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Dec era io .of Domicile and Citizenship ~
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TO THE CLERK OF THE CIItCU1T COUItT.
ST. LUG I E OpU~y, gj,pg~A; ~ 1
This is np devaratioo d Domfe~e aad is the State d. F7orid~ that I am ~t thb dq is aooaedsaoe. aad is
• aonto~mltT witb Seetioo ~.1T. t7oaiaa Statutes.
I was i~ a kgal:esideat d and I
1141 1&abJ
iestided at ~i9~0 /Yii9 /C rl/9/~ ' - Hawes. I bre cheesed tq domirlM to
18eeMt aid I~lea+D~rl ~ -
aad amsad haw heea a bona sde sesiaent dtbe State d ~losiaa aiaoe m~~' 9~ ~i d
19°v ' ana I seaias at /3S/ /~oyi9yE G'o a~T
p ~ tea..c..aN.~Me)
~ D~?T Si ~ H ~.,E ST . 1. UG 1 E CoaatT.I~7or~da.
IA41 -
aad this atateme>~t is to be takes as ~ decLrstioa d dtiseasbip. adoal Ieaal :er3deaoe sad domio7e is t>te State d ~~oeida.
" I f FOR THE PURPOSE ' Of ENROLL. I NG I f fOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE.tNECK:
THEIR NAMESi
f9P0 OCt ! 7 P!~ 2: 15 i
FtlEO ~eNC FLOE?Jf 0 ~
~ sr.LUCI cour+.Yrc:. `
- ROGER POiiRAS
CLERiI CINCUI; COL'R~ i
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I FtJRT~ 4`ERTII+'Y that I wiD resister at ~ iocai add:eas wbea the regestsatioa boob reopea. sad eompb with aII
other rpniremeata d a legal :aaideat d this State.
I FtJRTSER CEIt1'l~'Y that I hm oo iateatiou to return tom ioemer domia'!e. sad I fatead to semain is
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FJarida. pesnasoenil; . -
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Sw~aeotoaad enbee:ibed-beloee me this _LL_-dq d ~D.4T --~T• ~/c'i,C . ~ ~9. 33~.SZ
F~OGER P01'iRAS, CLERK OF CIRCUIT COt~tT , -
ST. LUGIE COUNTY, FLORIDA ~ .
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