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Declaration of Domicile and Citizenship ~
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ST. LUC 1 E apU~y~ gl,pg~p~;
Tf~is M apr dalar~efoe ot Do~aktk asd Citisea~ io tIN 8tat~ o~ ~'lo~ida tlut I am 8~ this dy? iA sooordana. ~ad ~a
eoatacenit,~r wlth 8~etion 2Z2.1?. I~'locidt 8tatut~. .
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I was t n~e a kaal rrsideat ot ~•cGdd,~t~~('11eD
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rai~d st Ho~w~ver. I 6+4w ebaa~d npr domidk t~o
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at~d am aod liaw beeu a booa tide raident ot tbe Stats at Flo:id~c siAOS ~~'~~1._ 9' dy? o[
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• 1~ sad I iwide at d • • " l •
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, ST. LUG 1 E.
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and tbb sta~ement is to be takea as n~ deeLration ot dt~senship. aetnal ksal resideeos aad domieik ip tbs &ate o[ Flarids.
Ii POR THE PURPOSE OP ENROL~ING . IF POR HOMESTEAD PURPOSES~
CHII.DREN IN SCHOOL~ P~EASE STATE PLEASE CHECKS ~
THEIR NAMES: -
~ ~~.P ' ~ , ~ 32048~ ~
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ST.IUGE COUNTIf Ft,A. ~
FL`~i ~ POiTRAS
CIERK Ct:~~UiT COURT
RECOR~ vF f •i~ED
Na~ 6 I 23 PH'~5
~ I FURTHER CEATIFY that I~?i71 ngister at my bcal addreu ~rhen tbe registntion books reopea. and comply w?it6•aU
~ other requirements of a legal resident of tbis State.
~ I FUATAER t I have no inteation to nturn to m~+ fora~er domieik. and I intend to remain in
' S T. L U t I E . County.
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j Florida. permanent,l~ .
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Sworn to and sub~cribed betore me this ~O day ot
' /~d ~%`I~ILL-~+~.v . A.D.19 ~
ROGER POI TRAS. CIERK OF C{RCUI T LOl~2T
ST. LUG 1 COUNTY, f I.OR 1 UA
BYs a~~,(~~, ~ ~
~ EPUtV LERK '
~ . ~ ~ bQ~~45 P~E1624
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