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Dec.Narat~on af Dom~cil~ and C~tizensh~p ~
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TO THE CLE1tK OE' THE CIRCUIT COUAT.
ST. LUG I E (SpUNTy~ FI,ORIDA: . •
This.is my declaratioa of Domicile aad Citi:enship ia ths State ot Florlda tlud I sm tiling thls d~? in aecordance. and 1n
eoaformitr with SeetIoa 2~.17. F'lorida Statutes. _
~ 1 was tormerl a legsl resident oi ~ h~ 4 Q ~
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resided at ~io~revee. I have cbangcd av? domic~e b
l8w~t ~nd ~
r,nd am and have been a boaa tlde nsideat ot the State ot Fbrida sinee ~ ~7?
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' ST. LUG I E
~ r-~ , Ca,uty. Florid.•
1~t71
u~d this statcmen~ is to be taken u my declaratioa oi eitlunsblp. actual k~l residence and domiu'le in tl~e Stste ot I~7orida.
IF~FOR THE PURPOSE OF ENROLLING IP FOR HOMESTEAD PURPOSES~
CHIIDREN IN SCNOOL~ PIEASE STATE PLE/1SE CHECKS ~
THEIR NANESt .
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I FURTHER CERTIFY that I wLl resister at my locat address when the registntion books reopen, and oomply wilh all
other requirements of a legal tesideat of this State. _ -
; I FU THE~~ EItTIFY that I have no intention to return !o my former domicile, and I intend to re~nain iu
+ T r C~ ~ 1~ . - ST . L UC i E . County.
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Florida, permanen~i; . ~ -
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Sworn to and subscrihed bcfore mc this _1~_. day of v
I . , , .
. . A.D.19
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kOGER P01 TRAS, CIFRK OF G tRCUI T COU2T ~ '
~T. LUG I E CGUtJT'f, FLOf21 UA ~
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BY : r ,
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