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Declaration of Domicile and Citiz~nship
' S~.4981
TO THE Ci.ERtC OF THE CIIiCUTI' OOURT. .
ST. LUG 1 E ~U~y~ ~,p~~;
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This is ~ declarat~oa oi DomieDe and Clti:ensbip ia t6e State ot Fbr;da that I am fling this dq ia aooordana. and is
o~nformit~ w-Itb Sectioo ?22.17. FZo~ida 8tatutes. ~
+ I was lormeri~ a kgul nsident ot ~Q/l.Q-o-i. ) , t'~ and I
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ns~a a ~`'oo ~a, _ .,8.11` ~ , EoWe,-u. i e.ve e~angea nq~ aomiAs b
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and am and l~ave beea a bona fide resident ot tbe Stste oi Florida siw~ce ~`~+ -• ~ g d~,~- d
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19~ and I reside st ~~_~ ~ ~P
ti, ~ ' ~I~, , ST. LUG 1 Esa..c.veN~ ~~. ~7orida.
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and this a4teme~ is to be tai~en as ~ deeluation at eitiunsLip. sctual kgal residenoe and domiu7e in tl~e State aI I~7o~ida.
' IP iOR THE PURPOSE"Oi ENROLLING
CHILGREN IN SCHOOL~ PIEASE STATE
THEIR NAMES:
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ii POR HOMESTEAO"PURPOSES~~-
PLEASE CHECKS , /~
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~ 1931 ,l~y 27 ~ i l; 17
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~ed betors me t~is a~ da~ al
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1 C~.ERK OF C IRCUI T COt~2T
~ ST. LUGIE COUNTY, FLOR1 •
~ - BY: ~
` . E~utY ~~ERK
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I FtJR1'~R CERTIt'3f tbat I~1 srgister at m~ local addnss wben tbe registration books nopen. aad eompb w~k6 aII
otber reqnireme~ d a legal raide~ at tbis Sw~e.
I F'tJ~ CF~iT~C tbat I 6ave no iatentiao to retnrn to lo~mer domic~7e. and I Intend to remaia ia
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