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~ 35'7835
TO THE CLERK OF THE CiRCUIT`COURT, ~ ~ ~
5T. Ll1C 1 E ,~,CpUiVTY. FI.ORIDA: •
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Thu ts my deelara,tion ot DomleUo and Citizenship ie the State ot Ftorida th~l I am filing th{s d~,p in ~ccord~ace. ~nd !n ~
~onfarmitr wlth Section 222.17. Fio~ida St~tutea.
1~?a [o~~ a kgat re~ident o~ , snd I '
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resided at ~~2Q,~ ~~~s~G,~ ~ Noaevee. I lu~ve ehanged mr domieile to
tster~t aae Nw.e.rt f~ ~
aod am and h~ve been a bona fide teaideat ot tAe Stste ot Fbrida siae~ ~ day ot
- ~f'~rL' ~ _...:19~, aad I reside at ~g ~ I DI''PS I Q ~f ~ '
__I'~1~5 r~. ~i' ~ V~' t~. ~ ST . l UG i Es~,..e..a rt~~r1 -
County. Florida,
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' ~ud this statement is b be taktn u a~ decbratioa oi attzemhip. ~Muat kgat resideqce and domicilst~o the State of Fla~id~.
If iOR TNE PURPaSE Of ENRO~IING IP FOR NONESTEAD PURPOSESi
CHttDREN fN SCNOOL~ PLEASE STATE PLEASE CHECKS
' THE IR NIINES: ~
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I FURT}IER CERTIFY that I w~i register at my iocal address when the regis:ration books reopen. aad ~ompty .w?ith all
othcr requiretaents ot. a Iegsl resident of this State.
I FURTHE:t ~ERTI ~t,hat bsve ao intention to rcturn to tny lonner domirile, snd I iatend to remsin ia
- - ~~I~ ~1IG ~ ~ ST . L u c i e County.
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Fbrida, permanenti~ , .
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Sworn to ~nd subscribed bcforo mu thU ~ aay of n?~ _ U,
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,R,~CER POI TRAS, C. ERK OF C{RCUI T COU~2T
ST. LUGIE COUNTY, FlOR1UA
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