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ation of Dom~c~le and Ci , p ;
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TO T'~IE C1.ERK 4F THE CIIiCtJ1T COUAT. ,
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ST L.UC 1 E OovN1'Y. t~'t~o~tID~ ' i
' deelac~tioa oi Doantcile u~ CjtisensblP ia th~ Stata d Fiocid~ tMt I an~ ~t this d~V ~0 ~0i'd"f0°' aad tn
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eoatarm[t7 witA 3eetia~ 229t.iT. F~o~da Stawta.
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I was t~ ~ 1~ ~~Qat o[ laca~i
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aad am sad bave beea ~ bona tide resideat ot ~Ae ~t~?te ot Floe~ida sina ~ z
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ST. LUG t E Connty F~o~ida.
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lt~t1 ~nee and domic~e ju the State a[ Fla~ida•
~d this statement b to bs take~ u m~r deelarst~? ~ citis~aal~. setualleSv
~F FQR HOMESYEAD PURPOSES~
{f fOR THE PURPOSE ~PLEASE`STATE PIEASE ,CHECK: ~
CH l IOREN t N SCH00l.~ ,
THEIR NAMESS
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r at my 1oca1 address whea the re8istration books reop~o• sad oomply with all
l FURTHER C.ERTIFY t~t I w~i registe
~ other requirementa ot a kgal resident ot tfiis Sts~te.
;i ana 1 intend to remain in
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€ Sworn lo ~nd subscribed betore me this
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~ ROGER P01 AS C~ERK OF C IRCU T COU2T
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