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D~ctara~ion of DomicilQ and Citi~~ns~ii~
TO THE CLERK OF THE CIRCUIT OOURT. .
ST. lUG 1 E COUNTY. FLORIDA:
This is aoT declaration of Domidle and Wtisenship is the State at ~7orida that i ~?an ~ this dp iu accordance. and is
oonfoemitT with Ssetioa 228.17. Florida Statutes.
I wss i
~ a kgat resident d ••1~~o~s~ and I
lG4i Bt~Ni
resided at yUb .b nQ,tinu - Sowewr. i haw ehaaged ~ domia'M b E
t ,mdl~eer! -
and am and have been a bona Sde resident ottee State atFlorida since /~r~~~~ ~ - f
~ S'~ ~ ~
.
{
/ • ~ 1! and I reside at ~1 ~/U/ S~ _ _ -
18ta~t asd Noobrd _
~~~o ~ _ ST. lUG I E Co~t~.Florida,
and this statement is to be taten as mT deeLration of dtisenship. adnal legal residence and domieIIe in the State aI Fiarlds.
If FOR THE PURPOSE Of ENROLLING 'IF FOR HOMESTEAD PURPOSES,
CHILDREN I N SCNOOL., PLEASE STATE i~`Pt,EASE tNECK:
HE R NANESS `
T 1 ~
19$0 MAR -6 1W ~ 04
- E a ~ I A.
EtEliit CIRCWi
- RlI~M YElgf1E
4'8421
I FL.'RTIlER CF.R1~'Y that I w~ d ap loeai address when the registration boots reopen. and oomph with sD
other rsgmrements at a legal resident of this State.
I FURTRER CERTI2'Y thst I have m iMcntion to r~etutn to m7 farmer domicile. snd I intend to remain in
_ _ 5T . l U G 1 E _ Countj.
~a4i -
Florida. permaneml,;. 1
~vUNTj,
•r t
l~t.,w `
. y~o~ _ ivg
cAaa~+•l
Sworn to and subscribed baton me this ~ da,~ oi_ _ - ~rct,._,c.e ~ ~~d _ _
~
A.D. i ~
ROGER POITRAS` CLERK Oi• CIRCUIT COt~tT
ST. LUGIE COUNTY, FLORIDA
-
Y
• EPUTY LERK