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Ueci~ra~ian oY ~omiciie and Liizenship
4549"r~
'1~O THE CLERK OF THE CIRCUIT COURT. .
S~. LUG i E COUNTY. FIARIDA:
This is up dseLration d Domide and t~ltisenahip in the State d Florida that I am flias this daT is aooordaaoe. and b
coaformit~ witb Section 222.1T. F'brida Statutes.
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Iwasi~akgalresideatd yir;~inia reach. Va. andI
tCit~l ltt~W
rnided ~ ~K?CSI~[XK:~lDCC~'. 5753 N. 8t t awn Rd. Hoverer. I love changed mT domia7e to j
tattast and NmaD~s1
and am and have been a boas bde resident dthe State d Florida since 4th dad d
~ 1
~u,0ust ~ .19'79 .andIresideat ZOOl S:~uth 10th Street
tSs:..c.adNoob.rl ' i
~nrt' r; Arc,c+ ST. LUG 1 E
ca~?
and this statement is to be taken as mT declaration d citizenship. actual kgal residcaee and domiale in the State of Florida. .
IF FOR THE PURPOSE Oi ENROLLING IF FOR HOMESTEAD PURPOSESi-
CHILDREN IN SCHOOt.r•PIEASE STATE PLEASE CHECK:
THEIR NANES: X
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nuahnn Anrjrn,~_$atnman Jr~
7
~9r74
X79 AUK i b PN ~ 21
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C ((TY. A.
t~IGJITTI~'OURfi
Rft:ORatIfRlftEO - '
I
I FUR1'HEB C):'ItTff'Y that I wi[! register u m~ local address whey the registration books reopen, and ocmplT with aD
other requirements d a legal resident d this State.
I FURZ'HEIt CER1'f1:'Y that I have no intention to return to mF former domie~le. and I intend to remain in
i orres ; UC 1 E CountT.
_ 16s~1 ~
Florida. permanend~.
t.
C=-"~ _ ~VS["~~t't A• Of1J...~,~lf'fl`I
Sr'"'. fix.'.:., a 'C~ E' (Idame~
1V~IE G~uN
2n~1 Sni.th 7 ntF, Sty,
Sworn to and sobeaz'bed before me this daT of ,I, *-1 Q ~n _ i
nrt Pi nrr T
ROGER POITRAS. CLERK OF CIRCUIT COURT
ST. LUGIE COUNTY FLORIDA
' . ,
BY: -
T
' EPUTY IERK
Bo'~3~4 ~a~1~86
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