HomeMy WebLinkAbout01708~~ 1 222
- - - D~ciorotion of ~om c~ eon~~itizenship
TO THg STATE AND OOUNTY TA8 ASSBASOB.
St . Lucie t70U1~1'y, FLOIBIDA a
This is my declaration of Donnidle sad Cltisanship in the State of Florida that I am Aling this day in
aooordsalce, and in conformity with Chapter 282, Section 282.17, Florida 3tatutaa.
Church Hill Tennessee
I was lo:merly a legal resident oi.T_----_-___ ---____-. -----------...--._-__-
----- (Cis) ___.___ (Stste)
Route 1 -_ _._---, However, I have changed my domicik
and I resided at_--------- ----------------------______.__-- ----_--------__-_--
----
(Sirssi a~ I+;nmbez)
s <_~ >L__-~ s.A_.. ~ tin..e wrls ,,a:td.n,t .+! ti.. ctttw n# ~`ior~a since - - 1 --...-- -- - ---~- - -------~~
w auia ~ ~aau aa... ti .r.+.... .. ....~. x... ~ ~__ ___ _ _ - - -- _
_..-._._~g~~~~__ __---, 19~, and I reside at-1109..._GSII,rgi~y"nLe __--
Fort Pierc_ e _ _ - _- _- -----__-_-- St. _~ucie -____--------^----_----.County, Florida,
ccca~
and this statement to to be taken as my decLratioa o! citisenahip, actual legal residence and domicile in
the State o! Florida. a[ yropert~
form >hao~ imW~ ~ domteDe. y~re~ of~oa~e.~e=ee~~ui~Lm~at o~ ~mploym~a! ~t
Entering Douglas $ombailey in 1~lementary School
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91180
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;;~.IUCIE COUN1YaFlU~~.~A~
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I FURTHER CERTIFY that I will register at my local address when the registration books reopen,
and comply with aU other requirasnenta of a legal resident of this $tata
I FURTHER C~R'1'IF'Y that I have no intention to return tQ my former domicile, and I intend to remain
~ Fort Pierce ~ St. Lucie -~~,~ *~
(t2b)
Py7• : ~,,
• ..toward Bombailey
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$wont tp and subwibed bedosls see thb~....day of ~~ fit t... hda~ --
.,
Roger Poitras, Cler)r of Circuit Court ;~~ ; :~ jam, ,,~:.:,.3, ;
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