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D~cQ~rat~on ~f ~~m~cile and C~~oz~nshop ~
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TO TlIE C1.~;RK 0~ THE CIRCUIT COUtiT. ' 3~5289
ST. LUC 1 E apurrry, Ft.o~n~: .
Tl~is is my dectaration ot Dosnjcilo and Cithce?,+hip ia tbe State ot Ftorid~ th~?t I am filing this day in aecordanco. and in , `
eontora~ty with Seetion 222.17. Fbtid~ Statutes. ~
] w~s for~ a lcga! rc~ident ot rn~ -~'9"" - snd 1 i
tCit71 lSt~te)
~~~'~~:,,~~v~~ - Iiowevcr. l have ebanged my domicilc to.
1 and Num~e~1
and am ~?nd tu?vc bcen a bona fidc roaident ot the Stato oi Florida ainte day ot
19~ and I nside at , ~ _ ° •
18t+~t aad Nus0~r)
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~ t~ v~ ~r _ ' ST . Lt1G I E ~ County. Florida,
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aad tAis statemeat is to be taken as mr declaration oi citisenship, actual legal resldence and domieDe in ihe State of Florids.
, IF POR TNE PURPOSE Of ENROI.LING IP i'OR HOMESTEA~ PURPOSES~
CHILOREN IN SCHOOI~ PLEASE STIITE PIEASE CHECK: ~
THEtR NANES:
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t ~'~~"~.~..~1_~~~'-~ar~S~~.L ST ~ D A Fp
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• ROCtr~ ~3t1R FLA.
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1fRx ~~;~_~;~IT CCURt
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I FURT}lER CF.RTIFY that I wil! regi~ter at my loca) address when the registralion books reopen. and comply ~vitb all
i othcr rcquircments ot a Icbal resident ot thu Stale.
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~ I FURT iE;t CER~F~' that I have no inlention to return to my farmcr domicilc. and 1 intend to remain in
~ o ~ ST . l. U C I E , Cctiunty.
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~ } brida. permancnti; .
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SKOrn to pnJ subscriLc.d t,eturo mc thiy d~y ot ~~,s~T u
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RnG~R P01 T S, Cl_ERK OF C If:C.Ui T CO ZT t
ST. LIK I E: COUNTY, F l_OR 1 t)A . '
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