HomeMy WebLinkAbout0329~3~c{ai-a~ian ofi ~on-~icile and Ci~i~~~is~~ip ,
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512602
TO THE CLERK OF THE CIRCUTT COUAT.
ST. LUG I E ~p~Ty. Ft,pRIDw; ~
This is my dedaration ot Domic7e and Gtitisens6ip in t6e Staf~e ot Florida that I am filing thia da~ in accordanoe. and ia
contormit~ a~tb Sectioa 222.17. Florida Statutes.
I w as lormerl~ a legal resident oi /~pq~~urr~ _ /L~Ct ~ Sric l~ SP t> S and I
(G517I lStats)
cesided at ~~ ~~~vP r,S ,~GC.~ ~~'~tp~~ . Hoa ever. I bave cbanged my dotnic~e to
(Street aad Namber)
and am and have been a bona fide resideat oi t6e SLate of Fiorida since ~ ~ 1' ~ dq at
,19 7•t' - and I reside at ~o2.a 3 .T ~nrr r. s~ ~~~ ;
~s+~t.na N~e~~
,~¢ r t ( 1 Pr f P , $T • ~-~ ~ E Count~. FlOZidi.
lC'st7)
and this statement is to be taken as my declnration of citizenship. aetual legal residence and domic~e in the SLate of Florida.
" -I F F'OR THE PURPOSE ~OF ENROLL ING
GHII~REN IN SCHOOL~ PLEASE STATE
THEIR NAMESt
r-
IP POR NONESTEAD PURPOSES~ ~
PLEASE CHECK: ~
1981 JAN -7 P~: ~ 06
~~~EU jnc «cuKaE n
5 RCGER ~OITRASa
CLEF.K CIRCUI? C^CUi~:1
4f~^~r'.'S'c :n C~/~ --
C/
512602
I FURTHER CEATII~'Y tbat I w~71 regi.ster at my local addres~ when the registration books seopen, and comply with all
other requirements of a 1ega1 resident oi this State.
I FURTHER CERTIF'Y that I have DO IDtCOt.IOA to return to my former domic~e. and I intend to remain in
l~n.~ n. ~. ~ v ---~ 5T * L UC 1 E , Count~.
tG~it~) .
Florida, permanenti~.
:~ • ~.~-: -~'•
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Sworn to and subsmbed before me this ~~ da~ o~
~ ,~~ ~an._ / 98/
ROGER POI TRAS~ CLERK OF G IRCUI T COCfir2T
ST. Ll1G i E COUN7Y, fLOR 1 OA •
. ,
BY: .~'~ -A,o--, . ~ ~
lS.d4
_ EPUTY LERK
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(Addresa)
f--ort f"iPrro ~L 33yso
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800K 346 PAGE. ~7
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