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Declarat~on of Dom~cil~ and Citizansh~p -
4'71553
To TILE cf.ERK of TILE ciRCUrr covRT.
ST. Lt1C 1 E Cpp~~ glpg~A; -
This is nq declaration of Domie~e gad (~eaship in the Stag et b'loei~L that I am fig this dy a acoardaaa. gad ist
tonformitT with Section T.rl.1T. Florida StaLutee. -
I was f
~ s legal trident at ~e •
1 ~ ~~1~~~ ` - -~eLy ~ I •
iC~) tetsW
resided at `1 ? $ Pith t X11 ~ Howe.er. I base ehaaged nq dooviole to
~ N..e~l
and am end Gave been a bona fide resident of the State ei l:7ocida aiaoe ~ t~ daT et
c k 15~., and I reside at ~ ~A k ~ ~ .
, ~ ~ ~ ~ ~ ST . L UG I E Ffoeida.
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..and this s4tement is to be taken as m,T declaration of dtiaenship. aetoal ~ residence and domie.~e is the State of Florida.
_ li FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CNECK: I~-I
THEIR NAMES: ~
- nd ~
o.Na ~o
- !T 1 rri Y_El
PWi~RAS
gA>flI C111GAT COIIftT
• RECORl111ERIf'R
- 4`71553
I FURTAEB CERI~IT•'Y that I wt7i register at mT local address when the registration books reopen, gad onmp{T with as
other requirements of a legal resident of this State.
I Fi1RTHER CERTIFY that I have no intention to return to mT former domiak. and I intend Lo remain in
- - ~ ~ ~ U C 1 E_-- _ _ Coate.
I iC~) -
Fbrids, permanenci; .
r
`1~~'Cn~lzli;,i~\~ Syr
i ~P
y, . ~ ~t~ ~n ~ a ~ y
' Sworn to a'~• nbed before me this daT of
A.D.1~_
ROGER POI TRAS. CLERK OF C IRGUI T COt~2T
ST. LUGIE COUNTY, FLOF210A
f
EPUTY LERK -
6~~7rt.J tl~E IG~ _
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