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Deciarat~on of Domic~le and Citizensh~p ;
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Tab b mp d~dse~tlon ol Doa~ieiM sad Gtisea~Mip ia tM S1at~ o~ ~'lorida tliaat I am 81in~ tAis dy ia aeooe~dana. aad is ~
eoa~emity witA S~etioa 22~.17. Floejda Statutas. . j
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eaid~d at ~ 2 _~i~ -~l ~ C'~. 8o~rw~e. I 6aw eb~ahd ay? domia'M to ~
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aed am aad baw Meo a boas fid~ sa~id~tottbe Stst~ aI Floridisinn s?
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~ aad thb stat~m~nt is to bs takes iu ~mp? dselsracioa ot sitizenship. setuat le~at s+aidesa aod doa~ie~e io tM State v~ ~'iodda.
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Ii i0R THE ~URPOSE Of ENR.OLI.ING IE fOR HOMESTEAO PUR'OSES~
CMiLOREN IN zCHOOL~ 1'~EASE sTATE ~~EASE CHECK:
tME1R NAMESt ~ 1~~
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LUCIE COUMTY flA.
ROCER POITRAS
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I FUATHER CERTIF'Y thst I ar~l resister at m~ bcal addresa ~rlien the registntioa tioolcs :copen. and oompl~ .vitb all
vtber sequiremeats o[ i kgal resideat ot this State. ~ - -
I I have ao intentioo to retnrn to aiy fora~er domieiM. aad I intead to remain in
F~~A~77~~/1~?~~ ~ ST . L tl C 1 E . Count~.
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~ Florids. permanenti; .
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Sworn to aad u bclore me tt?u day ot .T~~.,,..~-.,~1~t'-C~~, / c~ Q~ i
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ROGER P01 TRAS. CLERK OF G IRCUI T COI~tT
ST. LUCIE COUNTY, FlOR1UA ~ .
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