HomeMy WebLinkAbout0154~~. .
, - -
Qeclarotion ~f D~ .. _.
K ~ an~~fisenship
TO TH$ STATS AND OOLJNZ'Y TAZ A$S~YS84$, -
ST. LIICIE t70UNTla !'LOBIDA:
- This ~ my declaratioo of Doaaidk sad GYti~ship in the Sbte of 1~9orids that I am i3lini this day in
accordance, and in oonform~ty with Chapter 282, Section 222.17. Florida Statutes. .
I was formerly a ~ resident o! ?~PLATA _ ________y YAIaLAND _~__~
(a4) (Stab)
t,~e~ i ~~~r~ei &~.. - ~~ - ------- . . . _...... '~'~~~;'u~r T i~nvy w)+s~~rwe~,i ~ Yn ~tw
(Stawt sad Nna~b~s)
to and am and hove been a bona Sde resident o! the State of Florida, since--..___---- -----s__-___.__.-,_----_--day of
-------_ _-- D~oetber__-~_ _. 18 ~ , and I reside at__ ~4_ ~!3~~ Dom: port St _ Luoi~ ---
(8ts~aa~t and Nttmbr)
~__~_ >rort_ Pisro• _~ St.I,aoie ______~_~~^^_Countyj Florida,
and this statement is to-be taken as my declaration o! citisenahip~ actual legal residence and domicile in
the State of Florida.
f rmtt: mites. ~on~l of famih to now domleu~. pnx~a~ a~ bow oibe~n~~! o[ omD1o7-m~aL ~t
9iiss
Ins: ~'~i~' '~ Pr' 2: 16
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t •• ~s;~
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S.. LUCIE CGUNiY, Flpr,.,,A
I FURTHER CERTIFY that I will register at my local address when the registration hooka reopen,
bTjd ~u,,,ply w,~ji oil at; eF Fryuil`ementa ai a legal t+eaideat o! this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain
_ (citi)
permanently.
(Name)
ohn 13. Duke '
• Fort Piesos St.Lucie _--------------------__~,tyj Florida.
.. ,. ,~
Sworn to and aubacriy~i•ba~epj
Jas Hairy ~- , ' Jv
~/~
My Commission ezpir~e~
. •..,-, ,
..:...
4 _---day of
A. D. 18 Sl.
fit Lsse
(Addrea)
(To be e:ecnted in daDlkab and orisinal Aled wftti (aerk C.irettit Court, sad dapliewte with Tas Aeeeaer)
Bowen aapDl~ CO-. Plant Clq. 1'la.