HomeMy WebLinkAbout1602 . ~
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; ~ D~l~ation ot ~omtvlte and Cttize~ship ~ ~
T'0 THE STATE Mf~ ~OUNTY -TI1X X155~~SOR. . ~ ~
ST. WCIE COUNTY. RORIDAt ' ' '
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• lhls is my d~darstbn of Oomidle ar+d Gitise~hip in t!» btat~ of Horiida that 1 am fitinq this d~y tn aooordana and ~
in conformity with ~hapt~ 22Z. Section 222.17, Fiorids S~atuta. '
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3 .~-...---rs-~~!~ a !~a! r-~!.~+...* ~ _ _ N~aaII . _ ._A~ i
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and 1 rosidsd et $~3rle~ St~ _ Howew? I havs cha ~
n~a~ ^n~? domidl~ t
~ (SNeet and Nvmb~r~
. to and ,~m ar+d haw been a bo~a fids raid~m of the Sta» of Florida si~+oe 18th -
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19~., and ! rostde e~ _ 2802 lie ~
. . . (Strwt a~+d Numbsr)
lORT M6tqf. S~AINT WCIE COUNTY, RORlDA
and ti+is stateme~t is ro bs taksn as my dedantbn of dtis~nship, adual lspsl ~ide~os and dorr?idie in ths Stste of Fiorida.
pr~ert hem any pertinent fad:, such as sale of pnaperty or busine:s, or roltnqui~t of employmsnt
at fiormar domidle, removal of family b new domidle, purd~ase of hane, etc.)
wPP~Y~ng tbr haaeatead ' .
. t~ary Lee Jobason ia a rasident of Ft.Fieroe tbr 27 y~aara ~
. xer hasband is 2"tnm the Ialands ••p~~``"'~?` ~f
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. ROGER POlTR~S, CLERK + ~
LUC1~ C/UNTY, ft/R18A ~ ~ .
~ f fURTHER CEit'tfFY that 1 will rogister at r»y local addrsss when the repistration books ~eopsn, and oompiy wtth
all athar roqvirements o~f a Isysl rosident of fhis State. .
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t AJRTHER CER~'tFY that t hevs no int~ention to retum to nny forme~ domie~is, and 1 intsnd t~ remain in FORT
PIERCE. SAINT U1CIE COUNTY, FLORI~A, permanentiy. . - -
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~ T.ionel Joh~nson
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Pl~ary Les ~on .
Fl~bruary
Sworn to and wb~aibsd beforr n+e this 1~~ day of 19~-b1~..
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• . ROO~ rORRAS ~M1 _ .
GRCUIT ~
o~:~~`s~ • IVotary PuWk .
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; ` (Te b~ ~o~e~M~d in dup~aM~ snd e~~ fl)~d witli and duppaN wi!!i Tax As~ora
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