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~0 T~ Q,~RR OF Tl~ CIIiCt11T (COURT.
5~.. ~LUC 1 E ~ oOVN'1'Y. >:7ARIDA: - * -
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~;~'13i: is aq dedaratios d Demici~e aad Qti~asbip is the State of F'loeida that I am ~t tiffs dq itv~aoooe+diuouo. and is
. eoafermil,~ wltb Setts 222.27. Florida Statutes. -
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_ •-~wa`s~~aletatrrsidaatoi ~c.h~G. ~ _ .ands
resided at ' ~4-55 a- CG.A ~ ~ ,tL t.`~'' - Howeer, i b.rs ebanaad m~ do~ials to .
- rsas;..a t~loeb.el •
-and am and l~a~e been abo~Sde residentdtbe Stats d Florida ainoe ~
~ Q ~ ~ daF d
~ 3• .19
~
~ and I reside at ~ ~ ~ ~ ~ ASS e. ~ ~ C. ~n ~
18tr..cadlJambae) -
~~_~T L.,v..c \ ~ ~ - ST, luC 1 E count?, .
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and this statement is to be taken as m~ decLratioo od dtixensbip. actual legal s~esidence and domici~e is the State of Florida.
If iOR THE PURPOSE OP ENRQLLING If FOR HOMESTEAD PURPOSES
CHILDREN IN SCHOOLs-PI.EASE STATE PLEASE CHECK:
THEIR NAIiESS -
- ! - tom; ~..1 ~~sta~.~o -
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P
I F'[1RT$EB that I w~ register a3 mg local ~dnss wben_ the r,egistsation books reopen, and oomph with aU
other meats d a legal reside. aI this State. _
I FMK ~R that I love ao mte~aon to retaun to mf former domieOe, and I mead to remain - in
- T. U C I E , Connt~.
Florida. permanenil;. - .
- 1919 S€P 24 F~ 2~ 29 _
. _ FIL~ED~AkD PECOnUE O
S ROGER
POITRA~A~ - .
' CLt~tK CiRCUiT CO
- ~,C ~yr~ RECDRDYERIF(EO_ _ .
- .;,,....,;~T ~
5~..+aisfiiaoii~solilicis'bedbeforeme dajoi ~o ~-c- 5"C i C ~~~~y~ `
an t.~..~~~. ~ :yam
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