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TO Tt1E CLE[tK OF TItE C1RCUIT COURT. ~
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ST. LUG 1 E ~puN1'y, FLORIDA:
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'1'}~b b mr dcela~ation o~ DomieUe and Cit~cnahip ia the State oi Fbrida tAat 1 ~m fiting this dar in accordance. and in ~
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tontoninity with Scction 2L.1T. Flo~ida Statute~. ~ ~
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I wa ia~merl a 1e6a1 ~aident o~ ~ ~ ~ . -~~,~1~ and I !
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K~~ ' Ho~r~vec. I h~ve changed mr domicJe W i
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aad am aad have beea a bona Cde reaident oI thc State ot Florids ai~ee ~ ~ d~J? ~ ~
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7''..iGc-~ 19~iad I re~ide at ~
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~ -~'~~~t~~, ST. LUG I E Councr. Floriaa, ;
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aed this ~t~teweat ts to be taken a~ my dectaratioa ot eit~seo~hip. actual kgal rc~idenee and domicile in the Stato ot Ftorida.
If fOR THE PURPOSE Oi ENROLIING' IF FOR HONESTEAO PURPO.SES~
CHI~OREN IN SCHOOI~ PLEASE STATE PLCASE CHECK:• ~
tHEiR NAMES:
. S ~ 'l t'~,:r ~1~'i
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-f' ~Q G~ ~S A~Q REC ROEp
" f lE0 ~Y F~A.
. ' s~. WC1E COU
~ ~ RocEa Po~ta~s
~ - - - ~ fLEPK CIRGU~? QO ? ~
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APR I~ 9 44 AM'18
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. - 40a~99
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I FURTHBR CERTIFY that.I will register at my local addreu when the rcgistration books reopcn,_and eomply aith all -
~ other rcquirements ot a legal resident oI this State. - ~ ~
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~ I FURTNE:t C R IFY that I h~ve ao intention to return to my"`7ormer domieite. and I intend to remain in f
k • ~~'~~jc: _ $T . L U C 1 E _ County. ~
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Florida. permanenti~ . ~
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~ SMOrn to and aubsetibcd beforo mo thi~ day o~ - ~-~'ti~'
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ROGER P01 TRAS~ CLERK OF C IRCUI T COURT ~ y
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~ ST. lUC 1 E COUNTY, f I.OR t,UA ~
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AGO Pnrm 71 ?'1. ~
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