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Dc:.~w~-~.~ion of ~tnd ~i~ize~~hip ~
48614
TO THE CLERK OF THE CIRCUIT OOURT.
ST. LUC 1 E COUNTY, FLORIDA:
Thin is my decLration d Domia7e and Clti:enahip in the State d Florida that I am Sling this day in scoordance. and in .
conformity with Section 222.1?. Fioarids Statutes. _
I was former a legal resident d L' ~ W l y I
(StTI Stan)
resided at L _ E ~T S ~O ~D _ However. I Gave changed nqI? domic~e to
l8trMt sad Name»t)
sad am and have been a bona Sde resident dtbe State dFbrida since day d
S~ P~E/~B 2.19-!
%
- and I reside at ~ ! W t~. D c ~ /~eei~~~APr. s6 ii~
i8w.c sad N®e.r?
~I ~ C C ~ ST . LUG I E County. Florida. ,
- (pt~l i
and this atateceut is to be taken as my declaration d eitiunship. actual legal residence and domieSe in the State d Florida.
IF fOR THE PURPOSE OF ENROLLING If FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECKS
THEIR NAMESS j
f LED AMf ~ + _ ~0E0
R~. LUCIE ; K' i FLA.
- _ O~c 6 3 33 PM'~9
458614
I FURTHER CERT1F9f that I wi11 register at my local address when the registration books reopen. and comply with sv
~ other requirements of a legal resident of thin State.
E I FURTHER CERTIFY that I have no intention to return tom former domicile. snd I intend to remain in
y
i c ~ JT . L U C 1 E_ _ _ _ County. ~
1(Styl j
~ Florida. permanenti; .
~ouNr _
r
v CMG ? ~ ~
ac ~j ~
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~ ~~y0 ...a'r f`oe ~,~Esr~,y `'VC...LAC.~ Jy.:~A~ G ~ ~~C~
~ ~~'F cu+m•~`n~ 2yoo S. C. AGE ~ ~R1V~
~ ® tAadr•••l I t
r' / J ~ 1 i
swam to and subxn'bed beige me thi: day d /C C-E jLh~
~P.A[ ~ ~ . A.D.19_
- ROGER P01 TRAS, CLERK OF G IRGU I T COURT ~-~1~- n,c'.~-.~.
ST. LUGIE COUNTY, FLORiOA
BY: f~
EPUTY LERK
~o~K 321 PacE 2049
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