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0158
. . ~ . _ . . ..,T . c~~~a~r~~~~~~~~ ~~~~~~~~e~~ ~x~~~c~~:~~~~ ~a / . , _ ~ ; . ; . , TO TIIN: CL~RK JI~ TIIE C1ltCUIT CG4~tiT. ~ ~ l ~ ~ ~~a~9 `i sY. ~uG i e . ' ~ . COL~NTY. F'LOItIDA: . ~ , ~ Thfs is niy declaration of I)omicile anel Citt2enship ii~ 1ho Steto ot F'iorida lh~t I am iiling this day in nceardance, and in , ~ tontarmity Kith Scctian 2?'.Z.17~ Floride? Stetutes. ~ - _ ~ , s ~ I was torn~icrly a IcFal rrsident o[ ~ ~ t ~ ~ _ anc: I , _ ~ (Ciiy~ ' ( atel : ~ residcd At _ 2IoXevQr, I have hni~ged my domicile to ~ i _ > (Street arid Nu~n . : and arn and huvc bren a bona fide resident of lhe State of l~'loridn sin.o _~~~dl- ~--I day ot , i ~~l'LS~ ~ ~ .19~_. and 1 reside at ~ /.GY.~.[/`~ ~,,~r~tQ. - - - ~ ) , ~ • (Straat and Number) _ . a~r~~~' _ ~ i ~ ST, L.UC t E - - - G~unty, ~loridn, : ~ - lCit~1 ~ . • ~ ' ~ . ~?nd tl~is stalement is to be taken as my declaration of citienship~ actual Iegal rrsidence and domicile in !Ae State ~t Florid:i. ~ ; . ~ . - . ~ IF FOR _7HE PURPOSE •Of ENRO~.LI~JG . I~' FOR tior~~sre~a PURPOSES~~ ' ~ CHIL~REN IN. SCHOOL~ PLf.ASE STATE • PL~A~E CFfECt:: ~ - ~ ~ - 7}IE#R NAFIES: - _ ' • ~ ~ ~ ° ' . . ` ~ _ - . ' - - L_ fiLEO ~MU f~E!'ORDEO ' ~ ~ ~ _ . / _ ~T.IUCfE GCU41Y FLA. ~ _ . r ? R~~i ~ r:a i RAS ~ . - - ~ Gt.E}.~; `.':.,C~~1'! COllRT ~ ~ . - F~r~3cl c;r..r.E1 F - ~ . , - . - Mar i ~ ~ - ii 30 ~ - _ - . ~ ~ ~ ~ , _ - . - ~ ~ - _ . - ~ . _ - ~ ~ . . _ _ _ . - _ . _ . ~ - ; I FUIZT)IER Ch.R'i'IF~' lhat I witl rl•f;ister at my local acldress wher. ih: : r.Z;ist_r; 'on ba~};s reopen, and compl~ with aii ~ - othcr rrquircwcnts uf a lc~;a) re~idrnt o, this State. . . ~ - I, F=i~1RT}I[;:{ (~I;It!'I1'Y ih:~t I havt• r,~ intcn!inn ta rcturn lo m}• ic.rmcr ~o~~icitc, and I in!cr:d to r~~n:ain in - ~ ~-r ~--L u c t c . c:o~}~~ty, - (G;cy~) . - ~ Floricla, r~rrutar.~mi;. - - ' " _ - _ ~ - ~ ' • - - ~ _ - ~ . - t • ~ . - ~ ~ - ' ~ k - ~ ~ / Q i~ ff/ Z ~ ; ' ^y ~ - - ~ ~ _ ' J ~ - , - - - . ~ ,:~ft~,:., f - ~ _ ---~1---- - . i ~ •tnaa«rs~ ~ . _ _ j ~I ;~,5 ~ :;;r~~; n i~, r.n~1 ~.tit~ti~ ril~•.•ii Lrfcu a~r. It;i~: / c~r?y of _ _ ~ _^Y~~_G~~C.e ~ - ~~C~~~ /:.l J'.1_ ~ . _ (i(1Gr(:._~'OI'1f~~~ ;VC,I..I;f~l~ l7E-__GI~'~:UI ~_CQlF2T :_~t~r«~~~ : - - - _ ~ , ; , . ~ 1 _ ~~r. t_~~:I C c:~ut~~TYs ~i ~,~t ~c~r? _ , : . - - . C3~~: ' . ' . - ~ R ~^rJ ^ ~ r r~ u ~ ~t:~~i.'i. ii , j~f< ~ ~ ~ ~ - _ • f J ' : _ . . ~ - : .3.t~N J.~4 - . _ ~ { Si.L ~ t;~, ' . . - . ` - ~ <r• y:~,4j~i.s4~ ~ y!i i- - . . . . . - . . j ~~~~~~~~rv . ' . 'J ~i. e - ~ Q _ /~f~f~t~n~,;7t:.- 1 - ~OQlt FAG~ - - _ - ~ _ _ _ - _ - - ~