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~~~ 2fi X600
- DeclarotionSb~~I~+t~ieF~nd Citizenship
TO T8S STATE AND t70UI~1TY T~A~Zp A88aB80B.
Q~' T..~~ WVi~1.a1 ~WA~i
This is my declaration of Domidle and GYtisemship is the State of Ploarlda that I am nuns Chia dsy in
i000rdanc0. and in ~,OR1~01'Qiity with Cbapt~ ~. SeOtlon 282.17, Florida $btntsa.
Honolulu HaMaii _ _
I was iocmerly • fetal resident ~ ta4) ------ ---~ ta<aa) -' --___.
and I resided at-_____1,54 r~ wai Bou~i-ard _--•--_---------_-__-. However, I have chanted my domicile
t8treet gad No~b~e)
to and am and have been a bona nde resident of the State of Florids since_______l~th___________.--___----day of
161 Banyan Drives Port St. Lucie
-- Jules , I9~-, sad I reside at tevwc .a~i Nwsbs) _____---
Fort Pierce Bbrida _ ____Counb-, Fiorlda,
tcxa)
end this stat~t is to be tsken as my declaration a~ dtiseaship, actual fetal residence and domicile in
the -$tate a~ Florida. ~ .
((InNrt bae and ptriisest =~+. sueb as jai. d~ ~royart~ os bo~iew. or r.~nLhss.~t a[ M~ploy~t aL
loess doaidM, rmo~a1 ~ lasslb to nrw dasie~. d ~eww fie.)
gstabliah Reaideaacy ~,
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FlEO A!0 RE~DED
W..p~800K
196I.NW -4 AM la 35
ROGER POITRAS.GE~K
ti. UlIE CIUNiY~j RI/~
79/,~+~I
I ~ that I ~ a ~ t ~a~ tbis $hta hen the te~ratioa books recDea.
end witbi aD other regnire~ments
I F'~JIi'I'SSR (~ tLat I Law ao iatwtlon tD rstarn to nq- ios~owr desaidls. cud I intend ~ ~a
St. Lu~fe Coost~.l~oeida,
is Dort Pierce -
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. ~ - George X. Kori~~';' Sr. , ..:..._
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