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Declaration of Domicile and Citizenship
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ST. LUG 1 E OOUNTY. FLORIDA:
This is m,T deeLratioa d Dosoid7s and (~tisenship io the State d Floeida that I am ~ this daT in aocoedanoe. aad in
oootarmiti with Section 282.i7..F7oeida Statutes.
I was fa~mer a 1eaa1 resident d L X~ ~ ~ e ~~LY- and I
_ lClbl 18ea~W
resided at - r 1"~ - However. I have changed cqT domidle to
ea.n..e
. and am and have been a bona Sde resided d the State d Floeida since Q n r' ~ ~ daT d
~ .1l~~. and I reside at ~ I U Q ~Q~ 9'1 C t~ t ~ ~
l8se+st asa ZI.~D.rf
~br ~ ~I~ 1rCP . ST. LUGIE
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and this statement is to be talcas as ~ deelaratioo d dtisenship, aetnal Iegal reaidenoe.a~ domidle is the State et F7oeida.
If POR THE PURPOSE OF ENROt.~ING If FOR NOMESTEAO PURPOSES,
CNIIOREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
~ THEIR NAMES: ~
t e r i I n h t~ ~1~n~~(, S
- 482[x.51
I~ APR -7 PN ~ 05
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NFEII CIIICYIT COtNtI ~j~1
II I FURTHER CERTII~R that I w~71 register at m, local address when the registration boobs reopen. and ~PkI with ail
j other regairements d a iegal resident et this State.
f ~ -
~ I Ft1R1~R CERTIFY that I have no intention to return to farmer domicile. and I intend to remain in
U 1 E . Coaat~.
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~ . ' ' SM?oen to and snbseribed before me this ~ dv d ~C4-l ~ C' ~ ~ G ~
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ROGER P01 TRAS. CLERK ~ G IRCUt T COt~ItT .
ST. LUG 1 E COUNTY, FLOR 10J1
/ ~ • 4
~ BY:
~ EPUTY t.ERK
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