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- ~ 4'70043
'!00 TAE CI.ERB OF 1'~ G'IItCU1T OOURT.
S~. LUG i E OOUNTY. FLORIDA: ,
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~ `~'Thb js m~ declaration at Damia'le and Qdiaeaship is the 8tste d Florida that I am id'inE ti~is dp io aooordaooe. and k
ooniormitT with Seetioa 2?Z.1T. ~7orida Statntas.
- I was i~ a k`al resident d - cad I
ICigl , tBtaW
resided at '~'t-Q''~ - Aowever. I ha~re ebaaaed mT domia~s to
18tr..t cad rtasb.si -
and am end have been a bona Sde resident dthe State d1E7orida since 2 ~7 d
a ~~-a-f-t GLfr~
.19
3
0 • and I rtside at
18a..t a.dN®D.rl
- ~.,~.,Q,, cx ~ ST. LUG I E Count7.1<7orida.
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and this s4teme~ is to be taken as mT declaration of dtiseaship. actual legal residence and domia7e in the State at Florida.
IF FOR THE PURPOSE OF ENROL. L.~NG IF FOR HOMESTEAD PURPOSES
CH 1 LDREN 1 N ~ SCNOOt.r • PLEASE STATE PLEASE CHECK:
THEIR NAMES:
~ S~`lUC E ~ ' ~ FLA.
P.~;F~ .:S
- RECOF' i c: ~ ~ " r ~ '
4'70043
I F[JRTAER CIILTff'Y that I wtil register at m7 local address when the registration books reopen. and campy with all
other requirements of a kcal reaide~ of this State.
I FURT~IL CER1'lt'7C that I have no intention to return to m7 former domic~e. and I intend to remain in
_ T. U C t E Count. -
t(;a~) `
- :
Florida.. permaaentl;
.
- ,
t
.s
COUNTy
''oQ~ Sbi O S T O IIJ Cam" !J ~C. -
~7L ~ ~~e ~ ~ , fl 5 d
Sworn to and snbsar'bed before me this dq of :
ROGER POITRIIS. CLERK OF G IRCUI T COURT s
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•
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ST. ll1G 1 E COUNTY, f LOR 1 OA _ _
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EPUTY LERK -