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TO Tl l~ CI.El2K OE' THE C11tCUIT COURT.
ST. L11:. I E COUNTY, FI.ORIDA: ,
' This is my decleration ot Domicite end Citizenship in the SiAte oi Florida thai 1 am filing thls day in aecordAnce. ~nd in
contormity with Section 222.1T. Florid~ Ststutcs. .
I N~as formcrly a IegAl resident of ~ t' • and I "
ti t 1 Slats)
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residcd at . Ilowcver. I have thanged my domicile to
l8treet and Nu~nber)
and am nnd have bce~1 a na fide resident of !he State o! Florida since ~ day ot
~
.18 , stad I rtsida ai .S
(3treet ~d Num )
L~ ST . LUC I E County, Florids. -
1(St71
and this stalement is to be taken ns my declaration of citizeaship. actual legal residenee and domicile in the State oi Florids.
IF FOR TNE PURPdSE OF ENROLtING IP FOR NONESTEAD PURPOSES~
CHI~DREN IN SC1~OOt~ PLEASE STATE PLEASE CHECK2 ~
THEIR NAHES:
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I FURTHER CtiRTIFY that I wi11 register at my local address when the registratioa 6ooks reopen, and comply with nll
othcr requitements of s legal residept of this State.
I FURTH~Z CERTIFY thwt I have no intc:n±ion to rMurn to my lormer domicile; and I intcnd to remain in
. U C 1 E , Cour.ty.
IC+t~I .
Florida, permanenti;.
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Sworn te and subscribed be[ore me this dAy of ~
. A.D. Ig_ ~9 ~
ROGER P01 TRAS, CLERK OF' G IRCUI T COIf~T
ST . L UG I E COUNTY, F ~(Nt t UA - ~
BY : BUOK JV~ r~~E 9Q0 ~
EPUTY LERK
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