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Deslaratis~ ~R~NJ~i~-.and Citizenship
TO THE STATE AND (70UNTY TA8 A$Si1r980R,
St . Lucie COUNTY FLORIDA:
Thin is my declaration of Domicile and Cltizeaship in the State of Florida that I am l11in~ this d.y in
accordance, and in conformity with Chapter 222, Section 222.17, Florida Statutes.
Miss 1~~~1?Pi ----------
- -- - ----------. -- --------- (State)
I was formerly a legal resident of____Siulf_-P_4Tt~_--_--------------- -- - -
tpt7)
Troutman--A_ye. __ -- However, I have chanSed my d^*+"'c~je
and I resided at---- - -- - --537 ------- -- -------------- ------•
- (St:wi sad Nnmbes)
do acid ara and have ~n a lsara fide resident o! the Qt~te of F'len_da since ~ St-- -------------day o1
-- ------ Jul -~--------------------• 19_6 0~ I reside at-----~4uth-Iiat~LaX--~-----------------------------
-- (Street and Number)
F cr t Pierce S t .Lucie _ _ -County, Florida.
---------------- (Cib)
and this statement is to be taken as my declaration of citizenship, actual leSal residence and domicile in
the State of Florid8.
forme:rt domieile. pew i~ two ,e~~aomklle. pa~xlw: ~°:~e~aishment of .mil°r~.eat .t
B uilding a new home here
F;j EC ;~~:D _~~ECO
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I FURTHER CERTIFY that I will re~iater at mY local address when the re~Istration hooka reopen,
and comply with all other requirements of s legal resident of this State.
I FTTIt'i'EER CERTIFY that I have no intention to return to my foraisr domicile, and I intend to remain
~_~ F or t Pierce ,_~ .~____, _.-_ .-Co~?a~-. Florida,
caa~ ~~ _ ~ . iI ~
Pm'~m-ti7•
Frank
n to and sul~.crihed betos+e me this--3t~-_-aar at
s ~••• ''g adres s
~
wor
t
ft., Second
.~
A. D. 18..x..-~ ~- •~
~; ~:r4~ .~`- -
.
Idohrl PdbiN 6tstt lleeli~ st 1~r~e '' ~:-•' 3a U,~}.~,,,;~}y'r' ~ .
(r- bo .:.eoo.aGfaryikaa as .:i~..t ~61si w!u c~
ar iglieab with 'llas AssMSOe)
J. D.Eivans
St .
se..• arar cw, tta.c cus. ~+..