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Declaration of Domicile and Citizenship
4b~198s
TO THE CLERS OF THE CIIZt.'U1T OOURT.
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ST. LUC 1 E OOVNTY. FLORIDA:
Tbb b aq dsebtation d DomieDs and (~tisamhip is the 84te d 1<7oci~ia that I am lOba this dy is aoooedanos. asd is
ooatormity wltb 8eetion 2.17. Florida 8tatutea.
I was f rn a lesal r~eaidant d and I
~e-~~X iC14) 18tw1
resided at - However. I haw ehanaed mpr domieije to
left d Naa~~e)
. and am and have been a bona Sde resided d the Stag d T'7orida sinot ~ 3 - ~ dq d
~ 9 .1>l~ and I reside at y
ST. lUG 1 E .>z7orid~
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and thb atateme~ b to be ta><es as mT dseLration d titisenship. aetnal bEal reeidenos and domidle b tbs State d Florida.
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• ~ if FOR THE PURPOSE Of ENROLLING If fOR HOMESTEAD PURPOSES,
CNIt.DREN IN. SCNOOt.,-PLEASE STATE PEASE-tHEtK:
~ THEIR NAMESS
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_ a-•~-~-~%L ~'~l~'~s~-cam 7nR;N NARie~ 4bi1985
_ ~ APR -7 AM ~ 52
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• YEAIiIFO_.,,_.__.
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3 FIJIiTAER CERTIFY that I w~71 ruder at ~ locd address when the registration boobs reopen. and eomp~ with a>t
other requirements d a leaai resident d thb State.
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I FURTHER CERTIFY thst I have m inteatioa to return to former domide. and I intend to remain b
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Florida, permaneml, . -
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Sworn to and before me thb ~ daY d
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~ ROGER POI TRAS, CLERK OF C IRCUI T COCdI2T `~yo 1 N'R*~' w,! #S8
ST. LUG 1 E COUNTY, fLOR tOA
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EPUTY LERK "
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