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Declarat~on of Domic~le and C~tizenship
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TO THE CLEAK OF THE CIRCUIT OOUAT. ~ 318668
ST. Lt1C~1 E - o0urrrY, FtARCD~: . ~
Tbis L m,~r dectaratioa ot Dadeile ~nd Citiseaship ia tM Stat~ ot.F{orida tAat I am Glins tAh da~r in acooedanoe. aud in
coatonaicr «rith s«tion 222.17. ~'lOria. sawc...
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i ~ras t a kgal zesideat ot ,L~6.=1dG_ ~e~'~ ard I
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- e~esided at 1l ~ N~r.t/ oA~ ,~Y / - Ho~rever. I bavs ehangad a~? domicib to ~
(8hwt ~nd N~osb~rl • i
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_ and un aad bave beea a boas fids resideat o[ the State o[ Florida daee ~ ~Y
/~c•_~• - l~,Z's . aad I restae ac / 95D s fl/.~.v.0~i~ uE_
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sad this statement Is to be taken a~ my deelaration ot eitisenship. aclud kgal residence and domia'b in the State ot Fbrida.
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Ii iOR THE PURPOSE Oi ENROLI.ING IP FOR HOMESTEAO PURPOSES~ ~
CHILOREN IN SCHOOL~ PIEASE STATE P~EASE CHECKt ~
THEIR NAMES:
.~i4~iC ~~~e ' '
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.6A _ ~ l/t~Y/Y/ S '
• fIL~D Rkt+ aEC~RQEO
ST. LUC1E COUNtY FIA.
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• : 318668
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I FURTIiER CER1`IFY that I wn71 mgister at my loeal addses~ when the registratan books reopen. ~nd comply with all `
othcr requiremeats ot a legal resident of this State. ~
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ER~ tluit I have ao intention to return to my former domicite. and I intend to remain in ~
i c~. S T. L U C 1 E _ Couaty,
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[ Fbrids. Permanea~i; . i
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~ Sworn to and subacribcd before mc lhis ~ day oE
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~ 7~ A.D.19 i :
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~ ROGER P01 TRAS,, CLERK OF C IRCUI T GOUR1;::,_- _
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~ ST. LUGIE GOUNTY, ~l.OR1UA , ~ =
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BY: ;
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~ E TY LERK - .
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~ BOOK ~44 ~~E1843 AGO Form 71 2Z
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