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HomeMy WebLinkAbout1038 ~ i~~~~~~~~~e~n ~o ~~~~~~5.~ a~~ ~ ~ ~ ~ . . . ~ ' - ~ - 3Q~'~3g TOTt1E CG~RK OFTIIE CIRCUI'T COUItT, . ST . L UC 1 E COUNTX. FLORIDA: . . This ts my declarntion of Domicilo •nd Cilir.en~hip in the Stato o[ Florida that 1 am tiling lhis dsy in ~ccotdsnte~ •nd in . . conformity wlth Sectfan 222.17~ Florida utatute~. ' ' ~ . ~ . . I wes Iormerl~ a legsl resident oi I~~ ~i T~P ~ll ~~11 K k~ and I . . . (City) . (S~iittl restded at r.~:~ .~,x4 ~ J~LL~i . However, I hnve changed my domicilc to (Street t~,d umber? - - • ~ and am and have bcen a bona Cde Tcsident of the Stata of Florida since a~1 ~ a.y ot , ~ ' - .19 7~.. and I reside at 9 d ~ c~ W/eD _ - (StreK ~+?d Number) - ~Qr~ ~ S~ .~C vc../ C ~ ~ ST. .LUG ! E - Co~Aey. Florida, - . - . (cit~) ~ . _ . and this statem~nt i~ to be tdken us my declar~tion oi citi.zenship. actual iega! residence and damicile in the Stata of Florida. ~ ~ IF FOR 7HE PURPOSE OF ENROLLING . IF FOR HOMESTE~ID PURPOSES~ . CiiIL~REN IN SCNOCL~~ PIEASE STATE .PLEASE GNECh:- _ ~ THEIR NAMES: ~ - _ _ , - ~~.~.Ast n 4(.~.~ ? r9~ ~P f lo ' _ . . . _ - ` - _ J ~ l ~f 1'g 2 )91'1 ~2 ~ ~D - . - _ " FILEp AMO RECOr0E0 - - _ ST, i,UCi~ COUNTY FlA. • . ~ ClER1(~C RCUIf COURT ~ ~ ~ aEr.oaa vEt+~f~ED...~ ~ ~ - - ~ . . . ~ 9 9 00 ~!'7~ ~ - - - - - ~ 3~Q'~~g - . . . . _ ; . 1 FURTIIGlt CrRTIF] that I will register at rny local address wt~en the regis,r~ tion books reopen, and coniply .citli all ~ other requircinents oi a tcbal reside~t oi tt~is Stale. _ I FURTNE.t CF.RTIFY thwt I have no intcntion ta return to my former domicite, and I intcnd to re~nain in ~ - r7`` Sf -.<<,~C J~E . SY „_L u ~ 1 E , Counly. ~ (C,ty ) . - I~ lorida, pcrmancn! i; . - - ~ ~ - _ ' . _ - - . . - _ ~i.'. ~ . . . . . .~~~st#~6 `~~)~ir - • ` : t } ~y` . . - ~ ~ ik ?ij- i " ~ _ - ~ - . '.1 = j~~~"~s~~/` i ` ' - i: ~ `~:i ~ ~ , ~ti ~ ~ ~ ~ : . • ~ : : ~3: ~ _ ~ : J~~ ' _ G ' - - . - - •3:;3.. _ ' / . 5~`;r~;,~ ` "i'~'~~s~~' ~ . _ l~ti~~ • i _ - ,i# ~ f , •~-.'4~t-.~~ . . - . - Q i 1 _ a ~,si • ~ G=au~. _ ~ f ~ -~iF~Et~~~ _ - - ~-~Y~, (N~mc) . - ~ o~ 9 a..._:._fZ•. us~~` ~ _ ~ _ . tna~«ts) - - ~ ; _ - ' S~~•orn !o n s~i!?~r.ril:c~cl l,~~iore ~~~c~ I f114 (IR}~ O~ ^ y~~ ~ ~t.t.t,! . ~ r~-- • - ~ .~-_~-"c.t.i ~ A.n. )9 .-7 - . ~ F2nC, ____P01_l~Rl~S,_ C{_E=17~~__Oi- f IR~UfT CUIF.:T - 51',- LIIC I E f.OUt~lTti', F L~Jtt l,t)~ ~ f~Y : ~ ; , ~ ~ • ('lITY . 'i:i:it - . . ~ . . - - goaK 24o P~Eso37 . . ~ nc:~ r.,,?:~ ~ ~ t . - _