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' Dectaration o~ Domicile and Citiz~nshi i~
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TO TH~ CI.ERK ORTHB C1ttCU1T OpUitT.
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ST IUCiE `
• _OOUNTY. FLORIDAs ~
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This b ~a~r deeluatba oI Domieik ~nd Citisen~hip ia tbe State oI I~'b~ida that I am tWa= thL d~~r ia acoord~ee. aad ia ~
eoatoe~mit~r witb Seetioa 2~.1T. Florida Statuta.
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I~ras t merl a k~al reaidene o~ 6 L' y~~k'"d i • ~
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re~ed at 2 2 9 S'1',_
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S_,¢ l~C._____: Howwer. i~ave ehsnsed my donue;le ~o '
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and am aad ve ~a a boaa Gde resid~ptotthe State o~ Florida siaes ~ dy? o~ ,
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19~. aud I ~estd~ at ~
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ds2 7. L~. ST. LUG 1 E conncr. Fto~id..
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' aad t6~ statement is to bs takea ~s m~r dedantion of dtissaship. adual legal nsidence and domie~e ~n t6s State oi Flocida.
If F'OR THE PURPOSE Oi ENRO~LING Ii POR HOMESTEAD PURPOSESi.
CHit~REN iN SCHOOL~ PIEASE STATE PLEASE CHECKS ~
TNEIR NAMES: -
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' CtERK CIRC1liT COURT ~
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I FtJ~THER CERTIFY thit I wn71 segister at m~ {ocal addrass Mrben the rsgistrat~n books rcopea. and oompUr w?itA all
otber rtquirements oi a kgal ttisideat ot this State. ~
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I CEIt1'IFY tbst I ha~re. ao iatentiQn to retnra to m fora~er domic~e. and I intcnd to nmaia in
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