HomeMy WebLinkAbout0241,~
l~~cE~r~tEC~E~ a~~ ~or-~~c~t~ ~c~~1 ~~~~~~~c~~~t1tE~
~ ~ 514246 ~
7'O THE CLERK OF THE CIItCUIT COURT.
ST. LUG I E ~ pp~Ty. ~[,pRID~; ' .
T'his is m~ deetaration ot Domicile and Citjzanslup in tbe SLate oi Florida that I am filing this da~ in sccordana, and is
conlormit~ ~citb Seetioa 222.17. Florida Statutes. -
I w as formesl~ a legal resident of ,`~~- S/~ S ~~' T ~' S.s D U~-t~ and 1
. (/ tG~) ~ ISe.W
re sided at ~' V~ V~~~'~ N I~ ~ U~ , Hov~ever. I bave ebanged m,~ domic~e to
(St~ret aad Namber~
a n d am and ba~ e been a boaa Lde resident oi t6e State of Florids sina ~~ • ' d=7 ~
--~ ~l K. 3- ,19 y~ - ind I reside at ~ ~ ~ ~ ~~ ~ ~! r++ ,rt,/ /~ 1~
csc~.~aN~~t
~^. P~ C~ R C`~ . , ST. Lt1G 1 E Count~,Florida,
IRt~) _
an d this statement is to be taken as m~ declantioa oi eitizeasbip. actual legal residence and domic7e in tbe State oi Flor~ida.
" lF FOR THE PURPOSE-OF ENROLLING
CHI~~REN IN SCHOOL~ PIEASE STATE
THEIR NAMESL
.-
~~~`'1 ~fR ~ Irv ~, ~ ~ ~ 1.1 /
1981 JAN 20 A,Y ~ 28
f~IFG LtiC ~~COkGi ~
Si•LUCIf COUYjY.itA.
ROGER P01 ~ RAS
CLERK CIRCWT ~CU4i~
~f•; r,Fr ~ ,.; .~ g,~-- - -- -
v-
~J~~~
, -
' I FURTT~R CERTII~'Y that I w~71 register at m~ local address when the registration boolcs reopen, and eompl~ a-itb aD
~ o:her requirements of a legal resident oi this State. -
~ ~
~ .
I FUATSER CER1'If'Y thst I have no intcatian to return to m~ lormer domie~e. an3 I inf.end to remain ia
` ~ JT * L UC 1 E CountJ,
~ ~ IG~t~) .
~ Fioridn, permanenr3;. •
1 ~
~~~ c~~UNT c
~ J\` ~~ =~G~
s ~ : ' -.~,r-- ~ . C~
~ C/)
y ^. .-` •? %
- :; • : . _ • :~ _ -
€ S a orn to and snbsest'bed before me thi= ~~~ da~ a[
~ ~~~ _~.. /98/
E ROGER POI TRAS, CLERK OF G IRCUI T COCdi2T
~
~ ST. LIJG 1 E COUNTY, FLOR 1~A •
~ BY: - ~ ~ - ~-
i ~~~- ~N-~
, bEPUTY I.LERK
:
~
~ :y vr ; 1 - -
~~s~ ~ ~ 4,»=„r~ ~.~. _,. . . =
~ ~' i
i
;
. f
I
~
IF FOR HONESTEAO~PURPOSES~~-
~ PLEASE CHECK: ~
i
t~
(Nam~) ' '
IAdd~sasl
- ~ ~~
I-IA~ekL ess G. ~N N s . ~
~
. _ - , ;
~
,
~ ~ • . i
. -. ,
. - = ~~ ;
• . ~
~ .
" eo~347 P~ 241 ~ ~. . ; ~~~
t
~
-- - ' ~.4<:,;~~'~~