HomeMy WebLinkAbout1953.
:~ `_
Declarafion of Domicite and Citizenship ~~
' S11'~63
TO THE CI.ERR OF THE CIRCUIT OOUAT.
ST. lUG 1 E apU~y. ~,p~w;
Tlds is m~ deeLration ot Domie~7e and C'itiumhip in the State d Florida tbat I am flias this da~ ia ioo~rdanoe. u~ i~
eooformit~ ~it6 Seetion 222.17. F7orida Siatutes. '
I~vas torn~eri; a kgal rrsideat a[ ~~~l and I
. lt~~ 18taW
~~ u HoWever. I have ebanged ~ domide b
ISLeat aad Nmb~
and am aad bave been a bona fide resident af tbe State otFlorida sina ~C /_' f~/ Qb d~ a[
.19 and I rc~de at ~ 0 ~~"' ~ ~' /E~ L I~Q ~DT / ~
18trMt and Nomb.r)
~T ,OLF~CF- ST. LUG 1 E ~ti, ~,.;d,,
tav~ '
and thi.s statement is b be taken as m~ declaration d eitizenship, aetual kgal residence and domic~7e ia tDe State d~7orjda.
- IF iOR TNE PURPOSE Of ENRO~l.IN6 IF FOR HOMESTEAO PURPOSESi ~
CHIIOREN IN SCHOOL~ P~EASE STATE PLEASE CHECK: ~ ~
THEIR NAMESS
r-
~ooEC29 ~ii:ss .
- _~
' Fll EC eN[' ccCONDEO
SL l!lCIE COUMi Y. ~i A.
RO~ER POITRAS
, CLERK CIRC61i CO;:Rin , ~~
J ~~~{.r ~.~ F..~ ~: ~ ^~-~_ .
~d-
~ 511~~
I FURTHER CERTII9f that I w~ rtgitter at m~ bed address when tLe registration boob reope4 and oompl, witb a11
other reqnireme~s d a kgal rrsideM a~ tbis Swe.
I F(JRTHER CERT~'Y tbat I lu.e ao inteation to retnrn to m~ lormer domie~e. and I Intend to remain is -
~- ,T* ~UC~E ~~
IQt~) . ~
F7orida, permanemZ~.
`~ '
.-+ ~ t~ ,.r~~ ,'~i~r~~~~
,~,l±:;..:....,~~.. ~i~~i
s`
~ : ht'I~ .~~ ~'
:_- •~ G+ ~• - =
. ~ •R, j'~~~
., •• ' t 7j ' ~
s.• r ~ ~~:.. ~
~~- :~~~ ~
.~ ~~ `^ '
• i~ ~: ~
~
~~~~;..-~; • .. ' ,~ -:
~~e.1 • ~~~+a~J ti
~ • ~
~
Sworn Lo and snb~rnbed before me tb» ~~ da~ d
~~ - •
~ _ A.D. ig,~ ~ =
ROGER POITRAS, GLERK OF CIRCUIT CO~tT
ST. LtJG i E COUN7Y, fLOR t W1 •
,_
BY: ~ ~ •- .
EPUTY ~~ERK
~345 P~1952
. • ~,~~
. .~
.
~~ :
~~
;~
~
• J
~ r >
~ 3
. .- ~ r - • ~
~-- - ~it~ -t?.:.. .