HomeMy WebLinkAbout0277
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~ De~laratlon ot Domi~ile and Citizenship
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~ St. lUC1E GOUNTY, FLORIDA: r
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Thi: i: my declu~tion of Oaniuls and Citi~nship in th~ Stats of Florida thst 1 am filinq this day in aooorda~o~ and
4n oonfannity with Chepter 222. S~ction ~22.17, Florida Stariitts.
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1 was formsrly a leqel ~esident of -
(City) (Sta») T
sS~B 89th Stre~L ~~tor Qtis~n ~ '
" ~nd 1 rosided at - Flow~ver i haw cfiarpsd my domWi~ _
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to a~d am and have b~en a bona fids rosidsnt of the Stats of Florida sinos ~~'h day of
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, 19 . ~nd I reside at 1~7 ~~~n~ snd Numbsr)
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' lrORT MERCE, SAINT lUC1E COUNTY, RORIDA
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{ snd this stateme~t is to be taken as my dedaration of citiunship, actu~l leqal ~~idenos and domidle In thit Stats of Horida. ~~-ki
(Insert hers any pertinent facts, such a: ssle of properry or business, or rell~qui~m~nt of smployment
at former domkile, nmoval of family to new domicile, purchase of horn~, stc.)
" wppl~lin6 ior ho~es~te~d 1~JQ$
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. FlLEO AND RECOROED
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~ . BOOK
~ ` t G~~'~t-~,"':. 1964 JAN 21 AM I I.
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t=~:~ ROGER POITRAS
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~ ST. IUCIE COUNTY. FL RIOA t
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~ i 1 RJRTHHt CERTIFY that 1 will rogistK at my {oal sddr~ss whM the teqistr~tbn bookste0pen, and aomp~y with
all other requirements of a le~al rosident of this State. - F
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~ 1 FURTHER CERTIFY' that 1 have no intention to retum to, my former danidle, and 1 intsnd to remain in fORT
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; PIERCE, SAINT LUCIE COUNTY, RORIDA, permanantly. _
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L~nis Br~io c~"°e~r ~ ~
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I Eliz~bet~`d~~~loer , -
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sw«n a.nd wb~orib.d b.For~ ~n.'this J~au~ar~ ~ 19_.
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