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0405
. _ ' Decl~ration of Damiciie ~and~ Citiienship ~ ~ ~ ~ ~ ~ . . . . . . ~ . ~ . - . . ~~~sa. ; . . . . . ~ ''r.`- ~ . . . : ~ ~ TO TNE CI.~tK OF THL~ CIItCl11T OOURT. ' - : , . . . . ~ ww T ~ LUC I E - , W V~~; i ~ i WMDs1i • • . ' ~ ' ~ . - . ' . , . . . u - Tbb b ay? deeiarattou ot ~otnlcib and Citiset~hip ia tM State ot Fbrida tbat I am tiUna this dq~r iu aooordaaee. and ia - eontornatty with Sectioa 2xd.IT. Fio~ida Statutes. , - . , I wt~ I e~ ~ kgsl r~ideet ot _~~4l ~(/~L~~ -L~.._.__._.__~__.: ~/'I ~ I raided at - Sowwee. I Aave ebaaged aqp domkite to 18w.t aud t~we.~l / • . and tm snd baw bEea a boat fido teaideAt Ot t11s State o[ Flotida si4t0 ~ diyr 4i - i ~ ~~c rt v~' ~ C ~ - .c r'`t 19.,f sndl reside at ~g~~Nrd~l .~``~IC; P/C~c'~ ST. LUG 1 E Coi,ntp~ Flortda. tav~ . ~ aad this statement is to be takea aa mr declsrstioo ot clttr~eashtp. actud kgat reside~ee aad do~nie~e in the Stata ot Ffocida. ~ If FOR THE PURPOSE Oi ENROLLINQ ~IF FOR HOMESTEAO PURPOSES~ CHILOREN IN SCHOOI~ Pt,EASE STATE ' PLEASE C.HECK: ~ THE 1 R NAMES~: ~ ~ ' - ~ - ~ ;S~t~oo i ~ . ~ ~ : - ~ - . , . . _ o _ ' ' ~ ClEifK@C RCW C ~ ' ~ ° t' ~ ~E RliIED'rr'~'rr~ial ~ . _ - A~c_1~t Z sa PM'~ - . ~ 3'~'6363 I FUK'1'EIER CERTIF'Y th~t I~1 register at my kcal addraa wl~en tbe eegistratan books nopea. and comp(p wKh al! other requiren~eats of a kgal resideat of Lhis State. ' 1 F1U~~ CEItTIE'Y thst I have no iattntion to retnrn to my former domitiM. ~?ad I intcnd to remaia in ~ ~rL~2C.C , S t. L u e ~ e . Couney. tc~c~? . - . Fbrida, permanenti~ . - - - _ • ' ~ . - _ ; . , • ; ~ • ' . j : - y G`` . - ` ~.'r' = Gy ~ ~Y-. - ? . V J '.~~Y ,.iAti~1'-Z - .L/ ~ ~j ~ . ' ~ ~ i~( ~ _-.:Y }i~t ' . . . _ ~ J . ~"~~a,~ ~+Y 2 . • q~' ; ~ {l'1~S*~~ ~ t',' ~ ~ f . , - . 'Y ~ . • y. ~ • (~1 ~j~2~~ ~ • . ~ R, ~ "~+c • ~ ~ vR ~ ~'t ' ~ T„- . . . • ~ ' :`-'O;' f ~ ~ - , : - ~ITLM'~ I~~ ~ IIQ~'~'t,~ ~ tAddrN.) Sworn to a subscribed beloro me this dpy of '~~FkCF' F~ f~ - ;3.~ -Sd . f ~ . • . A.D.l9~. . ~t R AS CL RK OF C iRCULT COU2T ~ - ST. LUCIE COUNTY, El.OR10A • - . • . . • . • .f . BY: ~ , , - EPUTY ~ K ~ . . , ' • ; . . . . c , " ~ ~ ACOFora+Tt•72 , . ;