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HomeMy WebLinkAbout2463. , ~ - ! ~~~1-tt:.t~.•.1.-~ t: ~.`l t.~t-~ttt~t•~t~. C~tit.: ~•t~_~~.~..~i~.~~-i~ ~/ .`~i~ 7~~~ '!'~ Ti~E Cl.f R}: OF?HE CIRCUIT COURT. --ST. Lt1G 1 E_- ------CO11:.rY. r'tARinA: • . Thu is inf dec!ar~tion of Do~niule xad Cituenship iD the SLate of Flo: ida t}:at I un f?iag this daf in hcco: dnnct. and in co,forrnitf w-ith Srction 'L`~2.17. ~'lori~!a S'.atvtes. ~. IKrsiormerl~alY~-alrrside~tof __ _-____St. _t.o~~is~ _ ___________~_____ _r:issouri ______~~ai - ~`_- IC~~1 cS•~.:.el ~ 1915 3ookbi.n ~er ~~ ive ~ Nou e~~et~ I hn~•e c2:~nbed ra}' do:nicilr to ~~•s;dedat------ ------- - -------------- (St-r~ .~d N~-ber) ~ ~ ~d am ~nd'. _~~e be~n a bo..a fide reside~t of the S'.r_•.e of Florida since _?~~a ___ __ __ _----------- ----~'~~ of ~ecenUer 80 1885 Grecndon Ave. - - - - - ----~ 19----~ fnd I reside at _ --- - -- - - --- -- - -- - - ----- (S ~-r-': rs 31: L ~~-:s) :'ort ~t. Lucie ST. 1_UG I E _--~,',~tj, F;~.-;~4 - ---- - - -- - ---- -- - -------- ---- - --- ----- -- --- -- - (Ci:~) ~.nd thu st-stemFat u ia be tf}~en r_s mf dc-c!~r~tion of citizer.ship. act4+1 ]egnl res;dence f nd do:r•~~7e in ihe S'.~ie oi Florida,. " I F FOR TIiE PURPOSE OF' EhROLL ING I F f OR KOldESTEIID PURPOSESi Cii1lDREN IH SCNOOL~ PLEASE STATE ?lE/~5E GNECK: T H E 1 R h/~ M E S t ~----- ~ ~tacy Danielle Leibo~~~itz '- S~ ~0`73. ~van :'ict~ael L,_iUo:-itz _ `` -. I;;;,O D:~ 31 F:s I~ 29 - f:• ~:. tt.i ~ Cu~r= f • S1 il'Cli CCJR"t. f : ;.. ' ' ROr ^F ~CI i R :5 ~~ Cl'_£Y..,:'_.,.. :: :F ; ~+ . = C';. ~ ~ ~. F . . ~~ I FI~~THrR CERTIFY t~:nt I a-~71: eb~~t,Er at mf l~..a1 aoc.'.-~ess Fhen the reb:s:: ztion b:w~ks rco;.en. r~d co~plf ~i:h nD o_}.er rrcqui-ements o! a)e~l sesident o: this S•.ste. I FCTRTHER CERT'IF'Y th*_t I}:~~e ao intrntion to returc to my lc~er dom~c~e. ~nd I iat,end to rer~-_in in --- M U Y~ \ c;_ ` ~J [ 1 F- - ST ., . L U C i E . Co:mty. r____~_ IC'r.~) . "r ;:::;3a, pe: rr._tr.enu~: , .....,; . .. ~ i:,:r, • • .: " • ~! . • j •• ~'= _ . _; - - . ;'~- . _ •,. - .~ ~. G~~ ` ~1~- ~ /~'~~ _ '!`'~_~' . , . -- ~- ~'-~'~.~ ~l~u~~ ~ _~~~ss : ~ ~..~ ~',~ `~ cAa~.-~) ~,/ /~ 1 ~-~ o: n Lo snd Eubs~bed bpfo:e me this ~/ day oi ~~~ ~-~ A;,/Q~ ~-+t' '~~~!?~c~ ~ ~c~_c . ,tiD.~o.g~ = /' Q k 2. ~~i1~6W l ~Z . - ~ . ~ ~ ROGER P011'~2AS., CLERK ~ OF G I RCUI T CO~tT S~ ~~ ~ C~ ~~ - ~ ~ ST. Ll1GIE COUNTY, fL0210A • BY: ~ ~ ~ ~ . EPUTY C.LERK I ~- . .=ssa~?a.... .^- _..,-._ w . ...r... .. _.. . _ - . -. - .. .•_ , - ~ ~ . eo~r 3'~ •.,f:. : :~ I 5 ~ _ .z4~~? . . . ~~ . _ . _ - . . .,r~- r . ~. ~~`~