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Declaration of Domicile and Git~zenship
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Tom c~nlc oF~ clicvrroovlrr,
ST. LUG 1 E OOUN'1'Y. FLOFlIDAs .
T1Ja is ~ dedaration d DomkBe asd (~t~enship iA tM State d Florida that I am ~i this rip iw aaoordanoe. and is .
eoatoemiq wKh Satioo 81d<.17, Florida 8tatute~. '
• I was i
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n~a IKaI re~idaat d ~Q.~~~~ ~1 ~?le - , ~~~1 and I
lA4l i
resided st -~(~,1_~,
~ _ 1 r ?v~w~ ~ tr . - 8ow~?sl, I haw e~anaad dolaic~k to
tallest oral NrD~t!
and am and have been a boas Sde residert d the State d Florida sins ~ sT dq d
~c~ • ~ ~ .15.~~ andIrasideat -~lo ~M=ore ~ar'C . ~l.l;.~~~~ ~T "1~f"~
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Q ~T SZ. ~>>r i~ t~ ST. lUG I E Connb, Floeida,
and this statement is to be takes as aq deeLratbo d dtiseaship, aetnal legal resideaos and domiAe is the State d Florida. .
• IF FOR THE PURPOSE Of ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CNECK:
THEIR NANESS
Aug l~~'CIk ~pN~UP_
_ - _ X80 fE6 -7 PM 12~ 19
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I FtJBZ~ CEAZ'IP7f that I will r~isttr at mT local address when the registration boob reopen, and ooavp>, with all
other regniremeats d a Iegal reddest d this State. -
I F[JB'1'l~ CEItTtFY that I have no intention to r~etnrn to iormsz• domieSe. sad I intend to remain is
- - U 1 E , C~t7.
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Swan to and sabaeribed me this ~ daT d QT_
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ROGER POI TRAS. CLERK OF CIRCUIT COt~2T
ST. LUG I E COUNTY, f LOR 1 OA •
EPUTY~ LERK
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