HomeMy WebLinkAbout0058~~C~a~'alt(~~l Q~' ~QI'~1tGtI(.' c`~t1(.~~ l~t`tf~~~l1S11[t~
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:Y~ THE CLERK OF THE CIRCUIT COURT.
ST. LUG I E Cp~Ty~ I~-LpRIDA: '
This is a~ deelaration of Domicle and Cituenship in the Stata of Florida thst I am Sling thIs da~ in accordanes. and is
conformit~ aitb Sectian 2?'1.1T. Florida Statutes. ~ .
I R as formerle a legal resident of ~'~/~~?/~~' S _ // and I
1At71 tSt+W
msided at ~ ~~NN4~k~K'~~`'~ Ao~ever.I bave cbanged m~ domicile to
ts~c.~a rr~~ .
a nd am and have been a boaa fide resident of tbe State of F7orida sina _.s~~ ~' ~~e da~ a~
-~'R= '_ 19 ~° and I reside at a~ ~ R~EA
o~er S's' ,~wc~r' ST. Lt1G i Ese~.~art,~~r~
~ - Count~. Florida.
1(st7) _
and this statement is to be taken as my declaration of eitizenship, actual legal resideace an8 domic~e in tbe State oi Florida.
" IP FOR THE PURPQSE'OP ENROLLING
CHIL~REN IN SCHOOL~ PLEASE STATE
THEIR NAMES:
~am~~
1981 J"~~~ 19 A~± ~ 53
. Fll:e e~;~ ~:.c~r~:~~i,
ST LUCfE CCUN! Y. F+. ~.
ROGER p01Tfi:.S
. C~ERIi Cl~CJIT CC~r~;; ~
~~ ~ i..'~4't t'i ~' • ( ^ ~ - - -
5141 _40
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i I FURTI~R CERTII~'Y t6at I~71 register at m~ local address ~vhen the registratioa books reopen, and eompl~ v~itb aII
` o:her requirtmeab of a 1ega1 rssident of this State. .
I
~ I FURTAF.R CERTII~'Y that I have no inteation to retnrn to m~ former domieile. and I jntend to nmain ia
` fvw.~.~ rr .~..~.~ -. ._ . ST , L UC 1 E , Count~.
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~ 5~ orn t,o and snbscn'bed before me tbis ~ 9~ daj ad
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~ 620GER POI TRAS* GLERK OF C IRGUI T CO~tT
~ ST. LUGIE GOUN7Y, FLORtOA •
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I BY:
<~'~ " .l)EpUtY i.LERK
f
~r" .Y~ ~~~~~: r ... .. ~ 3
' _':t}a2.-`-6~
514140.
IF FOR HONESTEAD"PURPOSES~ -
PLEASE CHEGK: r
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GI~~1eS l~. De~j~ JR. .
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- _ ao~ 347 Pa~E
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