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HomeMy WebLinkAbout2437 , , • . R . . ~ ~ ~ ~ , ~c.~~~~~d~¢~r~ ~n ~~~a~~~~~og~ 1 ' . • . , . ~~a,, . TO T1tA~ CT.~;RK 01~ TIIE CIRCUIT COURT, ~ ~ ST, LUC I~ COUNTY, FLORInA: ~ . . . ~ Tl~is Js my declnrntion ot I)omicito end Citlzenship in tfio Slnto ot b'loride thnl I am liling this dAy in accordc?nco, And in . eonformily with S~ction 2~.17, Florida Statutc . ' ~ • I wes formcrl ~ Ie al resident oi D~Y OK~ D ? . .~.~.Y fi , ' ~nd I iCit,~) . ' tSt?tc) ' restdcd At ~ ~ . Iiowovcr~ I hn~~c chnnged my domicile to ; (f,lrrct u~d Nu:nber) • ~ i - ~nd~am and hnvc Ucen a bons fide resident of td~e Stntc of Florida sincv dny ot - - . - , C ~ O U t' ~ ~ 197~ ~ and I residu at ~ ~ _ / • ~v ~ . _ (Strnet and Numberl s; ~ ST. I...UG 1 E County, rlorida. lCityl 'i . - ~ And this statement is to b~ taken as my declaratioh ot citizenship, actual lefisl residenee and domicilr in lhe StAtc of Flurida. . _ i . ~ ' . IF FOR TNE PURPOSE OF El1RO~L ING ' .I~' FOR H01•fE~7EA0 PURPOS~S~ _ CHILDREN IN SCfi00l~ P~EASE STATE PLEASC CHEC~: THEIR NAMES: ~ - ~ ~ ; : 3~p~?~ ~ - - ~ ' F1iFa ~ - i . . ~ sr. ~.uciF co FcoRa~~ ; . - ~ ROCL~R POlT~~S~, ' CLERx C1RC~tl~ Cp~~T ~ ; : RECt?RO VERIFIEp . 'r~~ ~ ~ _ ~ 1 4~ p~ ' . _ _ . . ~ _ ' - . . 'j . j1. 1 Y ' ` I rUItT1ICR Cl;RTIP'I' that I~vill rcgistcr at my tocai ~ddress when thc rcgislrs.lion bva}:s rcopen, and comply with all 3'• olhcr requirements o[ a Ic6ai msidc~nt of t~~is State. . _ - . it~ ~ I FURTI II~' Cr TIT~ . ti~at I havr_,,~o intcnlion t~ rclur~i to my formcr ~omicile, and I intend to remain in - ~ - - pe _S~`'• L ~c %c , Sr . L uc i c , c.~.~~~~ty, . ~ . cc~~,.~ _ - . ' 1~ loricla. permanrnti; . - ~ : ~ - ~ ' - - - i . . , ` ? . - . - - [y E i`,, I ,,,I. • ' / ~ . . - : ~ „ - ' r - i~ ' c; _ _ : _ : . - ~ ~ ~ . . . ~ . .1 ~f _ ' ~ ~ 1 . . - ~ ' ~ ~ ` lNA _ ~ - r~ : - ~ ~ •.'~i,~ ' : • _ ; ' ~O _ (AdJres~) ~ Swarn'tt~nn~.Ujizcribr.d befote n~e lhiy _ day~ of r ._!'.t p,7, ' • J.+Gc-f-~crt..~ , - . ' - ~ - _________.___~,L'~s._....- A.1~. l .s_ 7~ t~~~~rR _i~o i~r~~ns~ CLFRK Of"_ C_IRCI)I T COt~tl' _ - : _ - - - - _ ST. Lt1G I C~ COUt~lTY, F~:OR t U/1 ~ ~ ~ z C3Y : _ ~°~u~.e~- - ~ ' ~~Z~I:PUTY~I.LI2K ~ ~ t ~ . ~ x. _ ~$OOK.~G+~'~l1 PACf ~~~e~ ~ - _ , - ~rt~~~~,~,,~~~ ~