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4~6?881'7
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG 1 E COUNTY. FLORIDA:
This is my declaratioa of Domicile and Citirenship in the State of Fbrida that I am filing this day in accordance. and in
coaforauty with Section 222.14. Florida Statutes'. / ~
1 was fob a legal resident of ~ffZ~~ ~ I, and I
IC.K7-1 (&ate)
resided at ~ /l~! r°ty f . . However. I have changed my domicile to
18te~at and Nambar)
and am and have been a bona fide resident o[ the State of F'brida since 1~f1 day of .
19 ~-3 , sad I reside at / . ~ s , f O~f ~Jt:
~ (atraat sad Nnmbr)
_ ST. LUG I E Caunh. ~
(l~ql
and this statement is to be taken as my deelantion of citiseaship. actual legal residence and domicile in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES, i~
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECKS ~ i
THEIR NAMES:
s
Ro_~ I
AECO~+" i f
0~ 1 2 34 PM '.19
f
4881`7 1
k
I FURTHER CERTIFY that I wi71 register at my local address when the registration books reopen, and comply with all ~
other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return tom former domieHe, and I intend to amain in
' C 1 E County. }
1 7) _
Florida. permanenti, .
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'iri;~J^Jfi..Gfj~?~~ (Addraaal t ~
Swam `trd'duibed baton me this day of
R GER I TRA CL K OF C 1 RCU I T COURT
ST. LUGIE COUNTY, FLOR1~
y
BY:
EPUTY LERK _ ~
~fi~3~i >'~~1
.