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TO THE Q~RK OF THE CIIiCUIT OOURT.
-ST. LUG 1 E OOUNTY. FhpRIaA;
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T~`bp devsnUon d Domidl! snd (~[ttssnsbip is the Stste d Fbrids that I am iifjns this dq b aooo~daaos. sad b
eoaformif, wK>t Seetian 2?.E.1T.1!7oridt 8tatntes. -
I was i~ s kEsi rasidlnt d fem..-~i~7~ ~ - - - - - t~T nr; r1;a__ sad I '
. IClci1 tBtaW
tesi~ed ~ 27 n4 D .7 aw At~p,~ ~ - Harweiez.I bsv! Cbaased ~ dosdrlM to .
18traat aid Naobatl .
_ and sm and have bees s bons fide resident d th! State d Florida since .,vmj~r ~ da, d ~ _
~ _.,1S~andIresideat - ?fig :vim.
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~ ~ Pierce - ST. LUC-i E g~,r~,
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sad this statement is to be taken as n~ deelaratioo d dtiunship. actual kgsl residence and do®ieDe is tbs State d 1`7orids.
IF FOR THE PURPOSE OF ENROLLING _ IF FOR HOMESTEAD PURPOSES,-
CHILOREN IN SCHOOL, PLEASE-STATE PLEASE CHECKS.
THEIR NAM~SS -
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I FUIt'PHI~i CF.~iTff Y thst I w~ register st m~ local address when the registration boaka reopl4 snd oomph with aU
other requirements d a legal resided aI this State.
I FURTIIEB CERTg'Y thst I have no intention to return to mp former domiea~e. snd I intend to remain in
` C E Co+mt~.
Florida. permanentli
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- 49T8 OCt -3 -P!~' 2~-16 -
FILED ANU RECOkutU ~ .
ST. LUCIE COUNT Y. Fl A.
_ ROGER POITRAS -
- CLERK CIRCUIT C T
- I~cOao vERIFIEa_ -
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ROGER~~~iTRAS. CLERK OF CIRCUIT COURT ~~lfs7~ ~
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ST. LUG1E COUNTY, fL 1OA _
BY: ~
_ EPUTY LERK ~
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