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TO T11E Ci.EItK OF TIIE CIItCUIT OOURT~ • ~ ~ ~ ~ ~ . ~
._T. LUG I E Opt1I~TY. ~'1.O1ttDAs •
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'1'Ab b aqr dalnntton ot Domtcile and Citiun~hip !a tho Stat~ ot Flo~ida tbat I ara i'ilina this da~r !a aeeo~danee. and In
~oato~aniy witl~ Soctioa 22Z.17. I~'focida Statutes. ~
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t wu t~ a kgal hstdeat ot _ , . ~ i _
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resided at . J{cJl~~._ _ - Howovcr. I hans ehanged a~r domie~c to
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aed am aad have beea a boaa fide te~idcnt o[ the Stste ot Fbrida siaee ~ da7 ot ~
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U~!-~ 1~~~. aad I reside at ~l ~ /1/ ~/-~/e A/
~ ~ {BteMt a~d Nom~el
,~~T S i ~ v~ < C,_, ST. ll1G i E- ~h,, ~;d,,
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~ uid tbb:talcment ts to se taken u my declsrattoa ot sitiuaship. actnd kad resideace aud domic~e ia tbe State ot ~lorid~.
• IP POR THE PURPOSE Of ENROLLIMG If ~'OR HOMESTEA~ PURPOSES~
CHiIOREN iN SCHOOI~ PLEASE STATE P~EASE CNECK:
t HE I R NAME S S
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I FURTtiER CERTIFY that 1 wi11 registcr at my loeal addresa whca t6e rcgistratioa books rcopcn, and wmply w?ith aU
otber rcquiremeats of a lagal raident o[ this State.
I FURTHEZ CERTIFY tl~t I have ao intention to return to my formcr domicile, and I intcpd to rcmain in
• ST . L U C 1 E ~ County.
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4 Sworn to nd subseril?ed bcloro mo thU ~ day ot ~02~ ST L-{/C r t =
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ROGER OLYRAS,~ CLERK OF C IRCUI T GOU2T
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