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Declaration of Domicile and .Citizenship
48292'7
TO THE CLERK OF THE CIRCUIT OOURT.
ST. LUG I E OOUIVTY. FLORIDA:
This is np decoration of Do®ia'le and Cttisenship is the Stets of Florida that I am 51inF this daT is acoordaaos. and is
confocmit~ with Section 228.17, Florida Statutes. '
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I was fo a legal resident of A ~ ~I
A C ~ ~ and I ~
1Qc71 letate) ~
resided at ~ ~ However. I have changed mT domidle to E
(8tewt asa Nash
and am and have been a bona fide resident a[ the State of Florida since dU ~
1it~.. and I reside e
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18t:mt N_~
t a~~ i 1 y c, P. ~ ST. LUG i E ~ti, Fla,
cats
and this statement is to be taken as ap declaration of citizenship, actual legal reeidenoe and domicDe in the State of Floeids.
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" IF FOR THE PURPOSE OF ENROt.LIN6 IF FOR HOMESTEAD PURPOSES,
- CHILDREN IN SCHOOt., PLEASE STATE PLEASE CHECK:
THEIR NAMES2
~P,~ iPA
Lin/~ o ~ '
~t~iPG~r/~A /~.9
;!'ice
~0 APR 14 PN 2 14
L
E RE
sKR i~afTi~AS ~ -
_ iiti~K CNt@iNT ~ _
R[E!M VERIFIEl1~.~,`
- - 48292'7
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I FURTHER CERTII~'Y that I w~71 register at mT local address when the registration books reopen, and oomph with aD
other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return tom former domie3le. and I intend to remsin ~in
lCit7)
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Florida. permanenci; .
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• _:;~u 'i' x-99 /~o%/~,rJ Aci ~
/ / ~ (Hass)
(Addna)
Sworn to and snbsm'bed before me this ~ da7 of
Q " . A.D. l$~.~'~
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ROGER P01 TRAS. CLERK OF C IRGUI T ~Of~2T €
ST. LUG I E COUNTY, f LOR 1 OA ~ ~
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EPUTY LERK
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_ BOOK~~~?~7 PAGE~~ ,