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Deciaration of Domic~l~a ar~d Citizenship '
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TO THE CLERK OF THE CIRCUIT COUAT. . ?
_ 3T. LuC 1 E ooviv'1~t. ~"t.onm~: . - .
17~ b aq? d~el~catba ot Doaidls aed t~tissal~p tn tM $tab oi Flo~da th~t I am BNo~ t6is dyr ia ~oe~da~ra. and ~a
eoataeaiit~ with 8~etioa 222.17. F{orida Statuf~s. .
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e~+e~ a kgat resideui at yt~~L~2~' . 'e 'e 'Q aad I
~Q IGt~1 lat+W
t+afchd at ~ - Ho~wwae. I hsw c6~ased n~r doa~ieils to
llen~t ~M Nr.l..1
aod am aod bav~ bsen a bona 6d~ rMid~nc at t!» Stat~ oIF'fo~id~? ~ ~da~r al
~ ~.7 ~.~a i ~a. u ~ ~P T / ~a~` r s` .~X ~ ~
+ ~e~..E..rN.r«~
C~t C 1°_ ST. lUG I E Co~mt~?. Fforids.
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aod t6is ristemeat b to be taken s~ a~ dsdarat~oa al dti~eas6ip. aetwi 3~a1 rssidsnes aod domin7s in tbs Stats o~ Fbrida.
IP i0R THE PtlRPOSE Of ENROtIiNG If-FOR HOMESTEAO PURPOSES~
CNILDREN IN SCMOOL~ PLEASE STATE II.EASE CH£CKS _
TNE IR N/1MESt
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I FUItTHEIt CERTIFY that I w~l register at my loeal addres~ ~rhen tl~e registcation boa~ts nopen. and eompb with s11 .
otLer raqu~reraenis ot s legal resident ot this Stata.
I FUATHEi~ ~~ffY ~ I~bavc ao intention to r~eturn eo m~ foraaef! C
t~• and I intend to nmain in
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Flo~ida. permanentl; . ~ w -
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sworn to ana:abxribea befo~e rne chis ~ dar at ~~~..CL~.`e
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ROGER P01 TRAS, CI,ERK OF C IRCUI T COI~tT .
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BY:
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