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4 f~9555
TD THE CLERK OF1'HE CIItCUIT OOURT,
S'i=.. LUG 1 E CpUN~. ~,pg~A; .
~ `;'T6is is ~ declaration o[ Domia'Ia sad (Stiaeaship is the State of f7orida that I am ~ this daT m aooaedance. ind is
_ mnfo:mitF with Section 2?2.1T. Florida S4tnte:.
r' Iwasio~alegalresidentoi cs/ATe~/ XS«r~/l) ~Ir•w ~ oj~/t' ~/t u~ ya/F'!~" andI
lCK7) . t
resided at ~ ~ ' f'e L !
~ t/ /if L' a .S . j1- y l v 3 ~ U - Aowe~er, I have Changed m~ domitsla to
(Street sad Tlambes)
and am and have been a bona fide raideat os the State oiFlorida since ~-S 7 ~ daF of
~Iq~yA/py -19~andIresideat •~~•ZS /tlD~rr~/Q/PEY <.rltl'
- (Htssst sad Idumberl
f sg,yT ~ c~c 1 e sT. LUG i E cant,. Fbrda
~cn,?,
and this statement is to be taken as mT declaration of citizenship, actual legal residence and domia~e is the State of Florida.
I F FOR THE PURPOSE OF ENROt.t. l'NG I F FOR HOMESTEAD PURPOSES,
CH I t.OREN 1 N SCNOOt., ~ PLEASE STATE PEEASE :.FizCK:
TNEIR NAMES:
f lEp aM - -,gip
8~- LUCl~ . ~ . - : zU-
RO _
CLEf:!• ; ! „fit
RECD-'- . ;
- - Dec I?~ 41~ P4 ~9 - I
49555
I~
I I F[JRTHF.Et CIItTlFY that I w~ register at mT local address when the registration books reopen. and oomplT with all
other requirements o[ a legal resident ad this State.
F I FURTHER CIItT'iF'Y that I have no intention to return to m~ former aomiale. and I intend to remain is
.
T. U C 1 E _ ConntT.
t(Syl
Florida. permanend~.
~ [jQU~lTy a ~y~f-L.t~~
l ~ -
V' ~''•'y i~ ~fi, ~
•..y~:.;.. ~ •
Swam to and ~ F +are me this ~ daT of V O ~ L~ ~ ~ ~ ~ ~ ~ -
~ - _
L
'QCQMIIP~ ~A.D.19~~/ ~K4JE d. ~1~r~N
ROGER POI TRAS. CLERK OF G 1 RCU 1 T COURT „ . .
ST. LUGt E COUNTY, fLOR 1 OA -
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~ - - EPUTY t.ERK f1Y~r~2 _ ~iQA