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Dectaratian of. Dom~cit~ and C~f~zens~i~p
• 45'7154
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S~~ LUC 1 E -OOUNTY. FLORIDA: •
~ L ~ 1Ub is ~ deeLration e[ Damiciis sad CM3seasbip in the Stag et Florida that I am Suns this dy is sooo~rdanoe. and is
eo~atee'tdf,T with SKtioa 222.1T. Florida 8tatntes.
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I was i~r a ksal resided ei -
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reaiaea at a a `1r~Q~~.~i ~ S1
~s o - Howe~rer. I bare eleansea aos aomicDe to
tse~t.edHaoDw1 - -
_ and am and Aare been a bona Sae sesident of the State of Florida since - ~ eI
~i . ~ ~ -1!_~__Q and I reside at
- 18er.rt aadlios>asl
~r,~~ , ST. lUG I E Count7• F'larida. .
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and this st.tement is to be taken as aq declaratioa of citizenship. aduat kgat resiaena and domidk is tbs state of Florida.
1 f fOR THE PURPOSE Of ENROLL. 1 NG I f FOR HOMESTEAD PUR POSES~-
CNI~DREN IN SCNOOL,-P~EASE STATE• PLEASE CHECK:
TNEIR NAMESS
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f I ~ ~'Y that I w~ regster at mT local address when the registration books reopen. and eomPl7 wkh all
other :egniremants d a 3ega1 resided of this State. -
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I >;'LJR'IZI>~ C~ERTI'FR I have no intention to return to mT former domiese. and I intend to remain in
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Florida, permanensl;. 19T9 SEP -4 All i~ 1-9
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Swop toaad sabeas'bed before me thus daT oi -4-J~-~y~;~ -
. - A.D.19: ' ~ - -
. .79 ,
R C K OF CIRCU{T COURT
ST. E COUN77, FLOR t - • ~ •
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_ EPUTY LERK ~ -
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