HomeMy WebLinkAbout1332-- ~ JMOp~ Pa1tl llorelc
ST, IUCIE-COUMTt. ftA.- . ~ . .
Declalrotion of ~ Domicile and ~itizen~ip
TO THS BTATS AND COUNTY TAZ ASSi~80It,
8':'- ~~ OOUN'1'Y. FLOEIDA:
This is my declaration of DomidJksnd Cit3selship in tl~e Stets of lso:ida that I sm Nia~ this day in
accordance, and in conformity with Chapter 288, Section 888.17, Florida Statutes.
I was former),q a 1s~sl naident of_~_H~'DT~..-__ TLT.77TnTA _~_._.
(G4) i :::
s,-.ti I ~~t.:ad at--_-- $~1~ _ ~.~~~~i.~QO ---------------- ----------------. gnwevar, I have chan8ed my doatidb
(8tra~t sad Number)
to and am and have tin a Dona dde resident of the :hate of -1~orida since---_-----____-- ~~----•---___dsy of
------------~l-- --._.__~, 18__~l,,~nd I reside at.__.LQI_S~erdel~_~!_e3.11~.~-------.---------•.--.-•-------
- - (8treat sad Number)
~'Qrt P~,4I•oe - $t.?.nci~_
and this statement is to be taken as my declaration of dtisenship, actual legal residence and domicile in
the State of Florida.
(Insert bate say pertinent facts, eneh as gal~e o[~ yroyert7 or bndnae, or reliapniel>meat od emplo~rmeat .at r
former domicile, tumoral of family to new domiefle, p~e~aee at lsom~ eta) ,.`~~~~:tll::~:;,,
J~+.` ~~
Entering three children in public school. = ~~- ~~ ~~,'~,•~~=~ -
1- NoL Jeanne p'lorek ~~`= ~ -.*,-~ ~~:_s • .~'
2- Peula Jeanne llorsl< 91942 ~::: - ~~~ .~_ _
~~ wi ~-wn r wnuua± ~ li:'rws 1 I~E ••. • ••...:
,,
'~•, a ~ i F
~,, ,,
1961 JAN 30 PF! I: 34
ROGER POITRQS, Cl~"!
S1. IUCIE COUNTY, FIOF-i.iA
I FURTHER CERTIFY that I will re~iater at my local address when the reyiatration hooka reopen,
_11L J7 _iL __ - .-L. _l' 1.-.l ..~~t~~.-L ~j LLS~ t71~L..
6LU l:Uill~ly W16II all ULIICC I'Cl~LLll-CiilClllB Vl 8 1C~(8l imlLLClli Vl 4iif0 OM-K.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain
Fort Pi er a e _`___--~ St . Luc i e _ ~~,~
~------------------------------------------- - --._-_ _-------------- _ Florida,
permanently. .!~
__ - --- (Name
oaep Panl FlareY
sworn to and i~ O N~lig~b~;me thia__ a0~ay of
~~rid~~3~~' ~•'•. ~-a• - A. D. 19.x.
(To be ese~f(i and orisinal Ned wit>b Uer1< t~:+eok Court. aDd dnplkate wits 'Pa: Aeseseos)
Ro.ron BDDDI• CO.. PI~OI ~Mi