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T01'U~ CI.EIii: 0~ THE CiRCUIT COUItT. •
ST. LUC 1 E CpUNTY. FLO]tiDA:
TAis is mJr dcclaratia? ot Domicik and Git'venship ia the State oi florida lbat 1 im Ti6n6 lhis da~ ia aecordnoct. and in
coaformitr witA Seclion 7.~.1?. t'brida Stawtes.
l wu formorlr a k~al tesidcat ot ~C~ ~~L /a N t~ ~ l Q/v i? . ~ i
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residcd ~t ~FA! fl ~5 /~~/L, L l~ O~ 7 _ ltawe~~rr. I Dave changed my do~ieilc t~+
l5ueet ~ed N~mee~) p /C^ ~
snd sm ~nd lu~ve been ~ bona tide residcnt o[ thc State of Florida siace ~a day of
. ~9,~',~. ~„a ~ ~~.t _L~LJlL • w M ~ .?C ~ E.
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' ST. lUC I E County. Fbrida,
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aad this statement is to be taken as my dectantian ot citizenship, utual lcgal r+e.aide»ce and domicile ia ihe State oi filorida.
~ , IF FOR THE PURPOSE OF ENROLIfNC IP iOR HONLSTCAD PURPOSES
CHItDREN (N SCHOOt~ PtEASE STA7E Pl.CASE CNECK: I~
7HE1R ,RANESt
o ~ . 1931~
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1 F[7R'l7lER CEItT1FY that 1 wi)1 regislrr at my I.~ca! ad3ress wLen the mgi~tntion 6ocks reopen, ~nd complr with all
othcr rcquiremcnts of a kral residcat of ihis State. ~
I FUILTHE;{ CERTIf'Y thtt I have no intrn:ian to miurn !o mr fornur domicilt, and 1 ia~nd la remain in
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Florida, pcrmaucnti;. '
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~ SK•orn ta ~nd suLceril~nl bclorc mc tAia ~ G day of C ~L~
. A.D.19
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~ RnGCR PnITT2AS~ CLC12K Of _CIRGUIT GOI~:T
~ ST. L C COUNTY, ~ i_Oft 1 UA
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A(:n t'.n ~n 71
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