HomeMy WebLinkAbout0429~.~~L~aE'c~l[C~tl O~' ~C~['t~IGEIG' r`~IZ(~ l:I~iP;C-l~Sllt ~
E
.
5143'71
TO THE CI.ERK OF THE CIRCUIT COURT.
ST. Ll1G I E ~pUN'~y, I~-I,pRIDA;
T6is 1s m~ decLratioa of Domic7e and GStizensliip ia the SLaLe oi Florida that I am filing this da~ in aocordana. and ia
conformit~ ~it6 Settion 222.17. F7orida Slatutes. ~ .
I w as lormerl~ a legal resident of .~~l1~~~ ~CL~" v~.~G_ ~ , .~~~ and I
1~t71 lStataf
re s i ded at ~"~ v~ ~_ ~~ ~~ ,~ . Hovicever. I ba~ e cbanged m~ domie~e to
(S•.ie~et aad Nmbe~
zn d am and ha~ e beea a bona Gde resident of tbe State oi Florida since ~ U~Z`~//Y~ da~
r
18~ and I reside at ~~~ 7 ~X ' ~~~~ ~~~~ ~C
.~ (5treet aad Number)
~~~ i/~,~ E,~l' c , ST. LUG 1 E co~~, r~oria~,
~~~
znd t}us stattment is to be talcen as my declaration of citizenship, actual ]egal residence and domicDe in the Staf,e oi Florid~
' I F FOR THE PURPOSE -OP ENROLL ING I F POR . HONESTEI-D~ PURPOSESi ~-
CHILDREN IN SCHOOL~ PlEASE STATE PLEA.SE CHECK: ~ ~
THEIR NAMES: •
' ~-!' ~ Z~?7Jlt~ • /'~ /' !~7/U~E~, S~N ' .
.- -
• ~,2 A-~l ~ ,~. ~ ~iv~ cx.J'~N . ,
.- - 198! Jd,i~ 20 P~ ~ 06
Fli~$ ~t+f iC{;r~::f ~
ST.IUCiE CO~~kt Y.(i A.
~ . RQGEi~ PQITk~ S ~
- , . CLERK CfR~Ut: lCv. ? Q
~:£~~Ef~ ~ ~ aii t~ ' i- -
' ~~~~
I FURTHER CERTTF'Y tbat I w~71 register at m~ local address vvhen the registration books reopen, and eompl~ ~vitb aD
o:her requirrmeats od a leg~ resident ot this State.
i I FURTHER CF~TIF'Y that I have ao' intention to return_to m~ former domie~e. and I intend to remain ~n
_ _- ~T , L U C 1 E ~~tj.
~7 .~"zF.2 <<tcscj) .
j r7orida. permane~;.
~, .
' .
' ` ' -
~
S R~orn to and snbsrn'bed befon me this ~~ daj c~i
- - ~•- %98/
ROGER P01 TRAS, CLERK OF C I RCUI T COCd2T
ST. LUG f E GOUNTY, fLOR 10A •
BY- f . "-
• `~~ 0~~/`~~ ~
, ~EPV Y ERK
:
~ ~.' .
~ ~'
l~ % . ~i i( , ~ ~ ,i~ .~_~
~~E~/T ~~ / ~?ltlfr"/~J:~i~ -
[./ ~ / tN.~m~)
~- ~-- ,~~ /
~~ Y ~.~ ~~-J ' ~~,~~ ~-
- `7_ c~a~.a ~-
~~• t L L~ ~ C C= L~~~I _ -
;
. • ;~
..
_ ~~'~ 347 P~~ 4~'8
' ••
,
. -.~
. ,
. _
, .
..
;-
~,~
~ =~ r~ .: : _ = - _ ~ ~
~~~~.~.-~-~ ~s ..-~;: , .. _ _ ,`~~