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• Tus is my decla~slion of Domicik an+! Citiseaship in tbe Sute ot ~lorida th~t 1 am Glia6 tius ds~ iu ~cco~dance. and in
toaformity witA ~ettioo 222.1?. Florida Statuln.
~ l wu t~ rlv a kgal rc~ideot ot L E'•~ /~~7e ~''S ~ ~ .
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tesided ~t /~11~J~/~ v (11,,,+~ _ lioweeer. I have chaaged m~ domicilo w
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aad am and have bcca a bon~ fide residcnt of thc State o[ F{orida siaee dsy ot
Q~~~~ Pv .,197,~_.~ndIrai~leat 30~ N.E.J'~ ry~i~l trrer-~-
(Str«t N~ess)
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and this slatement is to bc takca as mp declawtaA of eitiuoship, actuat kgsl resideaoe aad domie7c ia tbe State o! Fbridn.
• IF FOR Tt1E PURPOSE OF CNROLLING IF t'OR HOMESTEAD PURPOSCS~
CHtLDREN IN SCHOOI~ P~EASE STATE P~EASE C11[CK. ~
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~ I F[3RT11ER CF.ItTIFY that I w?71 rcgister at my bcal sddress whcn 1he rrgictration bao}s reopen, and comply with all
olbcr requirerr.c•nts oi a kgal resident ot thu Stale.
1 FUR'17~EZ F.RTIFY thal 1 ha~e no iatrnl'an to rrturn [o my (ormer dortti~ilc, u~d I intend to remain in
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