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Decla~ratior~ of Domicile ~~d citiz n hi
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TO THE CLERK OF TAE CIRCUIT COURT.
ST. LUG 1 E oourrrY. FLORIDA: ~ -
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This is ~ declaratbo d Domieib sad Cltiaenaifip in the State d Fbrids that I am ffiins this daT iA soooedaaos. and is -
ooalormky with section 288.IT. Florida Statutes. _ -
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" . I was f
~ a kgsi resident d o/'l ~ ~/f~ r~ sod I
resided st eiirft However. I bava ehaag~ed mar domia'le'to
and am sad lava bees a bona Sde resident dtheState d1F7orids aiaee - 9 ~ dq d
1l..~~. and i reside at ~~~Q,. ~L'`~~ ~ -
- _ - ~ ST. LUG 1 E Fsoeida,
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and this statement is to be taken a mar declaration d dtiaenshiP, aatuai legal residence and domidie in the State d 1:7srids.
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IF FOR THE PURPOSE Of ENROLLING If-FOR HOMESTEAD PURPOSES,
CHILDREN. IN SCHOOL, PLEASE STATE ~ PLEASE CHECKS
THEIR NAMES:
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/i/11L.
r- , _ -
. _ ~ DSO JAN 26 Ate ~t~ 41
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I FURTHER CERTIFY tbd I will resister at mar bat address wl~ t6e r~ratioa books raopeai sad ccmpb wig aII
other requirements d a kcal reaideat d thb State. ~ - -
I FURTHER CE~RTII~'Y that I Mve ao Intention to r+etura to m1 farmer domia7t. sad I intend to remain is
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~OCrER PO i TRASH CLERK OF G IRCUi T COId}2T ~ / g0 STpe -gQ~4SS
ST. LUG ! E COUNTY, FLOR 1 taA Pope T ST• L~ cue
BYs - _ ~ ~
EPUT LERK
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