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Declara~on of hoc?~~~cite and ~irizenshi
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100 THE t~~RK OF TAE CD;~U1T COURT.
S~. L UG I E ppv~y. ~,p~w: ,
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`;This is mT decLration s[ Damic~s and (xti:eaship is the State of l'7orida that I am 5>aos this d~ is aooordanae. and is
_ cuntormitj wltlt Section 222.iT.1:7o:ida Statutes.
I was ! a legal eesident a[ _ _ B'uf fad l~ Ytuk and I
ltw) Ist.ts3
resided at 704 .S~ Piue D>i%ve _ Aoweves. I bass cbangsd mT domies'le to
Itia~ asd Naas) •
and am and have been a bona Sde resident sd the Stile of Florida since i~tt ~ s 8 Y479 daT d t
19_~ and I reside at - it Pine I)~ve
ST. LUG 1 E ~,nti,
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and this stateme~ is to be taken as mT deelarat:ion a[ eitiunsbip. actual legal resideaoe and domicile in tabs State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOHESTEAO PURPOSES,
CHILDREN IN SCHOOL, Pt EASE STATE PLEASE CHECKS
THEIR NAMESS ma±y~.~..,~
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E
- 1919 A!!& 22 JW ~ 21
• S~LUCA OU~)1TY. A.
~POITRA
CIRCWT COIUtT
~ RECQRO ~'ERIFlEQ
I F[JRT'~R CERTff'Y that I w~ register at m7 local address when the registration. books reopen, and comp)T with aD
other requirements d a legal resident of this State.
I FtjRTIIER (~tTII~'Y that I love no intention to return to m7 former domicile. and I intend to remain in
T. U C I E _ Count.
_ tQa71 _ ~ .
Florida. permsnensi;.
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l
_ ^ , _`O
tTta+d
Zf]~ a~f . 8 F.~
IAd+....1
Swoce to and sabsas~ed before me this daT at !
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R CLERK OF G IRGUI T GOl~2T ,~'~~=i~~ y~''~~. ;
ST. LUG 1 E COUNTY, fLaR 1 OJ1 _ - •~V'I
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EPUTY tERK ~
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n~r:~15 P~ 44