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Declaratian of Domicile and Citiz~n~hip
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~TO T8S Ci.EEtK OF THE C11tCtJ1T COURT.
ST. Ll1C 1 E ~pv~y. ~~,p~w; .
Tf~ b mp deelarstioa o~ Doa?ieiM and t~tis~asMip ie tM Sts~ ol ~7o~ida tbst I am 81ia~ this dyr Ia aeootdu~os. sad ia
. eoafoemit~ ..itA s~ecioa 228.1T, E'bcida st~tut~s.
I was t em r a ksal raideat o~ /I o C~ s^T
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1CIyt leaal
r~aided st -~Zv ~'~,c/ !/~o -r - - - - - Ho~wawt. I b~w eUaa`sd m,~r doaai~ik to
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aad aai and Uaw beea s boaa Bde saideat at tLs &at~ at Fbeid: siaoe ~ .
l~ ~ ,19~~L..~iod I r~aide at 3 ° ~ 9 ~ r"~ .~!/a _
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-aud th3s ststsmeat is to be takea as mp deelaration ct dti~enship. utual legal reddenos and domidle ia the $ts~s ot FlocWs.
IF iOR THE PURPOSE Oi ENRO~IfNG IP iOR HOMESTE110 PtIRPOSES -
CHILOREN IN SCHOOI~ PIEASE STATE PLEASE CHECKS r j~
THEIR NAMES: 1--v ~
fILEp A~I;; t ~y
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CLER~t : ~-~;~iT COyAt'
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IVw? t3 II ~9 ~'~5
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I FU~~ER CEEiTIE'Y thst I~v~U register at m~ local address when the ngistratioa books reopen. and ~ompy with dl ~
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other reqnirements ot a legal reaideat of thi~ State.
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' I FURTHER CERTIFY tl~t I have no inttntion to retnrn to mT fora~er domiu7e. and I Intend to remain in
f • S T. L U C 1 E . Count~r.
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~ S~rom to sad subacribed betot~ me this ~`3 a,r ot 30 9~''Jw~ -S~ ~G~/~
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RO~,C~•~R~'i~t~A~:; ~CLERK OF G IRCUI T COIAZT
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