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Declaration of Domicile aYna ~i?~zenshi~
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710 T1I$ CLERK OF1'~ CIItCUIT COURT.
3~. LUC i E ~pUNTY~ Fjp~A; ,
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~;~'lbis is tq dee4ratioo a[ DamieDe and C~Seas6ip;n the State of Floridt that I am ~ this ds, ie aooo~+datoee. and ie
. _ eoa~mib wits Seetioa 7ClS.1T. Florida 8tatntss.
I was it a kEal re:ideat et ~ - _ ~E~ aad I
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resided at ~ 6 ~ ~Ki? .C - Aowewr. I bare tbasded aqT doa~ie3le to
tst:ertasi Iiambal
and am aad bare beea a bona Bde resident of the State a[ Florida siaoe -7~ da7 d
S? I•• . Isa1~ aad I reaide at 6 .S ~ ~sLE.t?~i
t8a~et asd A1o~sl~el
_T~L~' _SrT Lvaie.' ~ ST. LUG I E Co~mtT. Flaida.
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and Ibis statement is to be taken a: m7 decLration d dtiunship. acttul legal residence aad domia~e in the State d 1.7orida.
ii iOR THE PURPOSE Oi ENROL.t.1NG Ii FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL,•PLEASE STATE PLEASE CHECK2
THEIR NANESt
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cl.Ealc cu~clnr cou r
- RECbltD VERlftEt?
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'j I 1••IJR1'~Ei CERTIt'Y that I w~ register at mT loeil address when the registration books seopea. and oomplT with all
other regairemeata d a legal resident d this State. '
I
I F[JRT~t (~FKTII~'Y !that I baee m jntention to return to mi iormrr donsial_e_. and I intend to remain in
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F7orida. pvmanemii
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~ swsssteaad snbearibed before me this aaT d _ ~ e7~ sT L , f
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K- CIRCUIT COURT
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~ ST. lUG1E COUNTY,--FLDftlDiA..~~_.
E?UTY t.ERK