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4'7+0532
'FD TAE CLERK OF THE CDICUIT OOURT.
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S'~. LUG f E OOUNTfC. FLORIDA:
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`;This is m~ declaration of Daak7e and t~tiaeaship is the State o[ 1t~7orida that I am ni
io,~ this d~q is aorao:daooe. and is
_ mnformitT with Sedioa 2?2.17. Florida Statntet.
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' I was tormerh: kcal resident of ,.,~C--h?~ ~.~~.~-7-a- _ ` ec.~/ and I
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resided at - ~ ~ o ~ _ 'G.-~n~-~,c~,~,~ li'~ Aowe~rer. I lace ehansed mT domia7e to
- IStest Namb~ - - €
and am and bare been a bona Sde resident ottbe State of Florida since _ ~ . day of
' j 19 and Ieeade at - 7 r; r? . .G~i~-~ ~ -
~ _ ~C%zu••-e
18a..c..a Tramb.rl
~.f! a~.c~.cc ~ ST. LUC f E countT. Florida,
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and this statement is to be taken as m7 declaration of citisenabip. actual legal resideooe and domic~e in the State of Florida.
IF FOR THE PURPOSE OF ENROtIf`NG IF FOR HOMESTEAD PURPOSE ,
CHf tDREN fN SCHOOLa - Pf.EASE STATE Pt.EASE CHECK:
THEfR MANES: ~
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1919 DEC 2g ~ ~r= 35 _
FIItEO ~ ti00fe~E CrOr7pE-p
- _ - s ROC~iER
POl7RAFFS
~ERf(CIRC(p1' C@ItR
,i 1fFC@R8 VfRiFtftl__~~
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4'70532
I FURTHER CERTIFY that I w~U register at mT local address when the registration books reopen. and compl7 with all
other requirements of a kgal reaideat at this State.
I FURTHER CERTIFY that I have no intention to return to mF former domic~e. and I intend to remain in
T. U C I E _ Count7,
ICa~) _
Florida. permanenci,:
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Sworn b and sobsaibed before me this ~ ~ dal of - -
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ROGER POITRAS. CLERK OF G tRGUf T COl~2T 1
ST. LUC f E COUNTY, f lOR 1 DA -
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' E P U T Y 1. E R K I'1~N'k r~(T!'~(]' ,