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Declaration of Domicile and Citizenship
TO THE CLERK OF THE CIRCUIT OOURT. ~ v~3l~r
ST. lUC 1 E apU~y. ~,O~pA;
This k aqr deeiaration d DomidM and tlitissnship lD the State d Florida that I am ftHaa thb dy is aooordaoot. and in
oonfccmitT with Seetian 222.1T. )E'torida Statutes.
I wae.f a kcal reddent d /E ~ t
W ~ and I - .
IGV) ( si
resided st ~ / ~ ~ S f ~N D ~ t~ c - However. I bow ehansed ~ domicile to
lekewt asd 1~1~1a1 /y~ A
and am and love been a bona fide resided d the State d>`'bida since / ' 1 ~ ~ ~'-,1 dy et
pp..~7~ Q
3 1 ,lit 6 ' and I reside at ~ Du ~ s /"l~ X ~ 3•s
c12 E ~ ST. LUG 1 Eea..c.rH.~.rl
• Conna. Florida.
toil
and this statement k to bs taken s. nq deeiaration d dtisenship. aetnal kcal residence and domicils in the State d Florida.
- _ IF FOR THE PURPOSE OF ENROLLING IF FOR NOMESTEAO PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CNECK2
~ TNEIR NAMES:
-~L~J~NI1lE ~ivwE ~iC~)EIS
Sew I'~~~iE I~iC~cf~ 4032
1~'~; ~~~F l G~a25 ~ e/~Els -
19~ .APR -7 PM 2~ 38
• st~acltc~aar
~~R~Eo
~ I FiJRTIIER CERTIFY that I wRl resister at m7 local address when the reEistration boob reopen, and eompb with all
other regninme~s d a kcal resideat d thk State.
i
! 1 >!'URTHER CERTti•9f that I ha~re ao iatsntion to return to former .and 1 iatead to remain k
~~f - IQgI
l 1:7orida, permanentj,•. .
bra-w:an.T.,., .
F•' Gnu 1" ~ ~
t , ~ L
~ .r: ~ ~
J.:
a e'.•Z CG~~' r'
Sworn to and subeerksd befoe+s me this ~ daj d
•
A.D. i~~ ~ -
R A C K OF G IRCUI T Ot~tT_ ~ i
ST. LUGIE COUNTY, FLORtOA
-
BYs ~ ~ tIGE
EPUTY LERK
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