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TO T![E Ci.ERK OF THE C1RCUlT COUAT. , ' • :
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~ ST• LV\. ~ E r
~ ~ COUNTY. Fi.ORIDA:
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1'hb b my declaratioo ot Domicik aAd Attscrohip ~a tbt State ot Fbrida that I am fillag thls day in aeeord~aee. and in
eontocmtcr ~rieh Seetion 222.~7. Florida Satus~s. .
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t..u c~. k~st resid~at ot _ 1- A~4'~= u/ r G~/ I
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Howaver. I bavs cbanged my domicila to ~
IStn~t a~A Nn~~r)
and am aad lu~ve becu a boaa Gde resideat ot t!?e State ot Fiorida since ~a dir ~ '
19~., ~tnd I n~side at _1.~~?fl S~ 3 e.~ G/iC 1 A!G }/A m i C ~f'/l ;
~s~r.ec.aaN,~e.~i • :
~o IQ T S T I~ i.~ C ~t= ST. L.UC 1 E Countx. Florida, ~
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sad tbis atatement b to be takea u my dectaration of eitizee?~hip. aetual legd residence and doraiciie in the State oi Florida.
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Ii FOR 7rH~ PURPOSE OF ENROLLING If POR HONESTEAD PURPOSES~ _
CHILDREN IN SCHOOt~ PLEASf STATE PLEASE CHECKS ~
' tHE1R NAMES: •
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~ L~4 ANU REG IRUE G
S~ IUCfE COUkTY r~a
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_ - 41143f3
I FURTNER CERTIFY that I will register at my local address when the registrateon books seopen, and comply with all
otAer requirements of a lrgal resideht ot this State.
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I FURTIIER CF.RTIFY that I i~avc no intention to retum to my former domicile. and I intcnd to remain in '
' DdQT .ST L(~CG/c`- $T. LUCIE ~ ,
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F'brida. permanenei; . ;
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(Name)
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S~~•orn to and subscribrd h. tore r,~c this a? ~ day o[ R 1.~~ ~ 3 ySJ ~
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ROGF:R P(?I T~lAS~CLEf2~t_ Qf`C IRCUI'T COURT ~
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