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HomeMy WebLinkAbout1397 . ! r ~ ~ ~ I~~c~~r~ti~n ~f t3a~n~c~l~ ~?nd C~tixea~sh~~ ~ - ~ ~ t . . . , . . . 3~.pp4g . TO TtiE GLEnK OF THE C1RCUIT COt1RT~ 5T. LUC 1 E COt1rt'c~r, F't.oRinA: ~ • This Is my dtclaratton ot Bomlci{e snd Cil~enship tn the State of Flortda th~l I am lil3rg tbis day in accordanee, and in eonformi~y with SectJon 22`1.17~ Florid~ Statutes. . ~~ST DA~'ES s~ ' i I~rss fatmcrty ~ kgat nsldeAt at ~Y 1~1?~..=~~~~ ~L~XX~Nla~'~ u~d I tcnyl . csta~.1 resided ~t _s~6~ ~O~N/S ~ I~~ y - Hawever~ 1 have chaag~ed nny domicile to (Btn+t ~a~! NambK) • and ~m and hAVe bceb ~ bona lide naideat ot the State o[ Flosida atr~ce F FT ~ - dar oi ~1 ~T ,19~~ ~ad I reside ~?t To.b ~OX /8 9,,~ - ~F? ~i~1~~~?aVIT ~ _ - - (BErsK ~sd Number) f~D!?T ~T e~ ~ ST. Ll1C t E County. ~or~as, - ~ . - tas,~ . ~ ~~nd tAis statement is to be takea u my declardtion ot citiaenshIp~ sMaal legal nsidtace aad domicile in the Stste of Florida. - I F ~OR THE PURPOSE Of ENROLL ING - I~' f~DR HOMESTEAd PURP08ES~ CHILOREk IN SCHOOt,~ P~EAS~ STATE PLEASE CHkCKS ~ _ TNEiR NAMES: _ . ~ _ - ~ , ~ F~lE9 AMO ECOR _ ~ =r ltlClE C~U ~ _ _ ~ _ - ~ CLER ~Fis r41Tp~ ~ u'~ - _ _ ~ECOR~ V~R flf~ `~OIIRt~ ~ ~ ~ - . '~1 ~ ~ . . . - ~ ~ ~ - 9 s~ A~ ~T~ ~ - ; _ . _ ~ - - . 3~~3p~~4 ~ - ~ ~ - 3 . I FURTHER CERTIFY that I will register at my local address when the regislration boaks reopen, snd compty with all - other requirements of a legal resident of this State. . ~ . I`FURTHE~ CERTIFY that I have no intenteon to return to my .former domiaZe~ and I intend to remain in Pr~~ •~7~ Luci~ . ~ ~t. Luc ~ E . :Cou~ty, cCicy) . _ _ . . - _ Florida. permanenit; . _ • - . - > _ F . ~ " r'~ ~i~ - ~ . . . - ~ f - ~~v f~~1 . ~ _ . , ~ ``'~~~1~1~~ ` ' ~ , : 1~ ,~1 ~r n ~ _ . - . ~ ~ ~ Q ~ _ { - , ~ : V ~ i - _ . - ; 4,. . ~ra~G' : - - ` •~~l ~r~~ G/'~ ` ' - i_ " ~J ' Q ' K _ - • 3 e J<' ~ ~ , =s~~-_ i ~ ~ • - ~ j./}iy`~ w ''-+F' :1. ~ ~i ~ ~ . -'i ~ ~i l t • . i~` ` . 3 ~ +l 'z~ ~ . . _ . - t ~ y ~ ~ ! ~ ~a t V~ f , ~ ~ ~ . 7 /~~`t{t ) • ' 'Y4. . :~~ti <h . . ~ ~ ~~L ~f'~n~ ~2~7~l~~2 .~4P~t/Z 7' ' _ - _'t,;~` ~ T G~~~~4•` ~ _ " ~ " . . \ • '!''`r! { t'~~ii • ' i~?r , - ~ . . - - . . / i O ~Y"i'? / U ~..J ' _ ~ - - _ ~ ~ ~ ' r - _ , _ . - (Addrs~s) ~ ~ ~ - _ ` Sworn to and subscribed before me lhis day ot L„T. ~ i QGE . ICC.A ~3 ~J G+ _ . - t=`- - i-~_ . , ' ~ - ~ " f~/~E'S~77 c.~/ / N ,~?IG ~r~2~ r' - , A.D.19 75 _ _ - - , ROG PO ~ TRAS, GLER~: OF G IRCU! T COURT ~ ~ . - - ~ ST. LUC.I E COUNTY, F~tJR t.UA ~ - - - - ~ BY s ~ ~ ~ . EP Y LERK ; : ~ BQOK 24Q PAGE~~~ - . . • RGO Porn~ 9! •22 ~ . ~ ~ i