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HomeMy WebLinkAbout0975 ~ ~ . ~ _ _ _ , . . ~9ec0~rat~o~ of D~r~~~~~~ a~nd ~it~~e~s~ip ~ I . ~ - ~ ss8ss~ ~ . j TO THE CLERK OF TH~ CIRC~3IT C4'URT~ ~ ; . • ' COUNTX. FY.aORID~s ~ . '1'~b i~ my decluatba ot II~ouateif~ aAd Ati~ewhtp la tM Elat~t ~l t~'lorld~ th~t I•a~ C~llnt tA4 day ~a ~ccvrdana. and In ' contormitr witM S~etio~ 2~Z.~7. t'iorida ~tatat~s. ~ l ~ Mas ton~aerl a k~sl rs~id~nt a~ C , and I • lC~yl ISt..t~1 . - . . residcd ~t - . Nowevet, I ~avt cban~cd my doraic~e t.o (~erht..i N.oMr1 ~ - ~nd am ana Aave beea a booa Cds re~idtat otthe State ot Fbrfdt ate~e~ ~ , dar ot - - ~9 _ _.ra t,~.ta~.e ~E " - ~'~cc, ,~o~ ~ - - ~ (--t~ , __re^~ tstr«t .~1 Num~) . Couaty. Fiorida, lAy1 - and thJ~ statecneat b to be t~sa as m~ dcefuattoa a~ dt~en~A1P, ~ctual b~a! te~idetx~ ~nd domtcile [n the State of Florida. ~ - . , _ . x ~ _ - If for the Furpose" of er~rolling - children in public school, please - state their names: ~ - . ~ ~ . . , ~ . - ~ 1 FURTHER CERTIFY that 1~~1 re~e,ster ~t ei~ local addres~ Mhea t!u re~istntbc book~ reopea. ~ad complr witt~ nll other rcquiremeats d a kjal r~si~eoi ot lhis State. ~ ~ I FU TH~R CER tha I Aave oo intenlloa to return to mjjtyrtntr omit~e, ~nd 1 intend to remain ia ~ , .Q~T- . Coun~r. ~ - Ipt~! . Fiorida. permantatl~?. - - - 1982 DEC i a AN 9~ I Q ~ F ~iEr ~Nr R= coFr: - - ' S?.tlsGtF C~'i~!IT'r.~ t A. nc~~.~ ~•o~ir: s ~ ~ ci~~rcci~cuii c~c,~• /p~ ~ ~ C\JUNTy - ~ :i•-r_t• t't t? , _ _ ' ' \ '.•Gtf'iR" ~ . . . ~ ~ - cJ.- ~ ' ° ~ : ~£L-~~ ~ . S~'9~52 ~ ~s ~ ' ~:f.~ : ; - ~ - . .Y ` ~ - ~J 1~,,~~~r : ;o~ P ? l/ C ~ ~ ~~'~~iau~~''` i ne~ s ip~ J, ~ ' ~ ~R~~ r ~ . ~ ~ , Srvorn to at~d snbscribed bsione ~ot t~e dp $ ? ~ .E= ~ ~J~` - ~C' / L. " ~ . r-~ . n - . . - . Naane - si~n • ~ ~ ~,C¢%~ _ - A.D. it ~ Z ~ ~ ` ~ Narr~ - rint ROC~R POITRAS . (~,RK :~iR~C[~ ,IT QOiJRT _ _ . p - sr. wc~~ camTrSr, ~vo~un~ - _ . - gy ~ ~ - ~ : j . llEputy C er - . BUQKcX7~ PAGE e~ / ~ _