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~E:~.1tA~ ~1«v~ ~ v1 urVY1 jIV11~ u~ ~u v~ a~~c~~ ~a..,N . ~ . ~ . . . ~ ~ - . • ' ~ ~ ~ 344`?'~,5 . Tor~u~~~oF~iecu~currcovn~r, . _ sr. l.tx ~ E oovrrMr, Ftronm~ - . . • ll~b ts ~yr dedar.tioa ot DoeakUo ~ad t~tizea~ Ia tM S~ate ot FJo~da t1w! I iua ~b hip i~ thb dyr to aa«daaee. ~ad ta a~to~anty wkl~ Soctioa ?22.17. Flotjda Statutas. Z was t me a k~1 re~ident ot ~ ~ aad I ~ . K~41 l8tatd 4 ewided at l• ~ ~ ^ ~arer~. I bhrs eh~an~ed aqr do~aic~e to . . 18trMt~N~! • aed am aad ha~re eaea 6a~s tide ~dcnt ot tbe Stat~ ~ F'1o~da siaee ~=.,,,_.,,_,.._.__day o~ _._.._._SeL~C'~. 1~.ZSjt. ~d t e~ide ~t - ~C~,~; ~G~~~~'''..~_ ` ~ltG1~..~~ ~ ST. I.UC t ~`,.aN~ Gonutr. Flocida. ~ • ud tbis slateaknt b to be talcea as aq? decisratioa oi dtiseaabIp. utnd kgal residenee aAd donnklis id the Stste et Flaida. . ~f P~R THE PURPOSE Of ENRCI~ING IP FOR HOMESTEAO PURPOSES~ CH 1~DREN 1 N SCHOOL~ P1.EASE STATE PLE/lSC CNECK: ~ THEIR NAMES: - . . _ .~.~"~.~Q,~"...~e.~a.,._...._... . . • j r~~ • . ~ ~ ~ O~ ~ ~.~r~~ ~ . ~ 1'~ . sa ~ ~ . a~o~.'~~s d ~ • . ~h~o~ . ' ~ ¢yQ~~ ~ g~~ - ' 3~4'~3~ ~ I FURTHEIi CERTIFY that I~rll registcr st tny local addnsa alKn the tcgistrstan books reopcn, aad eampty ' vl otl~e~r rcqnic~ments ot t kgal resideat ot this State. _ 1 F'I~ItTHEZ CEItTI tbst I iu~ve ao iatentioa to retun~ to mr former doraie~e. aad I intcad to r~maiA in ~ SY . L U C 1 E County, ( i . : Flocida. permaaca~t;. ~ . ~ ~~~'~r~` • - . ~ ' . ~``i ~ U ~=-'~t[f ~~'~y'+G~~ . • , ~1 ri~,.. : vT• : ~~.6`'-`~..~~,jf~.~f~~~~,i~,~, ~ . • ~ .~~i" ~j• ,~?f~~!~=' Sll , _ ~ . ~ ~ , •,f~"~~~~;,,'j :~~`p~g~,' ~ ~ . ~ Y= = A~~ J~ -l~Z~ ;i - ? ~ r • ~~~~a1~1. * i: V. ~ •r~ i`~- f ~ :Z•~.. r ~ \ ~ i' ~ t • ~t - . . +d`~_; _ ~ ~G~ SC' ~ S .l~ o~ •~~-~-s~~ ' +,''i~rC'H N~ri1~~*~``, - .:~v- • ~ /~IwN~ `fi-: ~ ~ _ ~ct/[./ ~T ~~.r ~ _ lAddro~! Sworn o ~nd subxribcd bctoro mo this day o! , A.D.19_ 76 _ ~ ~ ~O~ER P01 TRASs CLERK OF' C IRCUI T COUtT . ST. LUC t E COUNTY, Fl.OR t UA . . ~ R 257 795 8Y: ~ ~ . gooK _ _ . . , . CPUTY LERK ` ' ' : ' ~ • ~ _ ~ - - -