HomeMy WebLinkAbout4892 Dec~aration of Qomic~le and Giti~enship .
2~~'~~92
TU Tllt: STATI: ANU ('C)Util'Y T:1\ ASSI SSOR,
S t. Luc i e ~•~~UN"~l`. LOR I llA:
Thi; is my Jrrlaratiun ot~ l)omiril~ ,~nd ('itir~i~ship isi thc Stat~ ot Floritla that I am tiling this day in
arror~laiic~, and in ~onlurntity with Section 17. FIori~1a Statutes.
I was lonnerl~~ ~ h~:il r~si~lrnt oi~ 1R121~8v1? l~ _ - - . _ F19r1s3a - - :~r~d I
(('ity) (Statr)
r~si~ir~ at - - _ _ _ - - - . Howrvcr. 1 h~vr changcd mti~ domiril~ to
ISUrrt and Numt~rr) '
ai~a :~m and havr hr~n a ho~~~ tidr r~sidcnt ot~ th~ State ot~ Hlorida since day ot'
- - _ . !9 6a :inc! ! rrsi~l~ at EQg Ei P?Yi~22~__~=1Y-~--_------ _
(~trrrt ~nd Numbet)
_ Ft ~ _ Pi.e~ce _ - ---~~_._L~,^i~- C'ounty. Ftorida.
tc•~~. ~ _ - • -
and this statrmrnt is tu br takrn as m>~ de~laration of citizc?~s}ii~, acieial lega! re~~dence and domicile in the State
~f Florida.
(Insrn herr an> ~~rrtinrnt facts, ~:u:h a; uh ot pr~~prrty ur business, or rchnyuishmrnt of rmQloymrnt at formrr
dumicitr. remu~al uf f~mih tn nc~c domicilr, purchasa uf h.~mc. rtc.l
I v~raa born in ~t. Pierce ~nc? ~o~, ed to G~in~sville ~ cr t~; eara
I have li~•ed here °or the l~st I3 ve?.rs
2~~~~892
fi~EO aNe !tECOR0E0
ST. lUC1E COUNTY FIA.
ROGEr ~~~Ti1AS
GLERK C~,~i.U1T COURT
RF~OR~ YE°''t~0..~.....~.~~
,1~ 3 4 3o PN'73 ,
I FURTHEh CERTIFY th:tt I~ti-ill rc`,i~t~r 3t m~~ Ic~ral :?J~i-rss ~~l~er. the re,zistration hooks reo~,en, an~t
rom~ly ~vith all othcr requir~mrnts ~~f !~~_al r~si~i~nt ot~ this Stat~.
I i=URTHf:R Ct=RTIF=Y ttr+t ! i~a~~ ne~ intrntian to rrt~~r~~ to m~~ tvrn~er domi~ilr, and 1 intrnd to rem:iin in
Ft. Pierce St. I,uc~e
_ . _ - - - _ _ _ _ _ _ . ('o~:nt~~.
~:~v~~d~,~~F.,,a.Fi:;7tly.- '
. /ri,j
,`\\~L cor.:.~j`' ' /
, ` ~ i ' „ /rl /
_ - _ _ _ -?u~~ _
~ ~ .1 : : 1\amr?
. ~ • ~ _ ~?o~ert ~or::on I:ee
~ ^ U ~ y 1 :
~ _ _ _ ~:~ed?cs~~ . - -
f .•'o'~ _
'~,~i'6r1~~t{~d~tZufiscribed h~li~r~• m< <f~;, 3rd ~l;iy uf
,
J~nury _.A.D. t~) .
~ ~~.7~
~ Nutar i'ubl~c Sfate ~~f 1 Innila at L.u
S i
`!y ('oi~~mission ~ ~rirr, Jznua r: - i ~ , ~u76
(T~~ hr r.r.uteJ in du~•h..~tr .~nJ ~rr~ti~n.~l f~lyd ~~~th ('~rr6 ('ucuit ('~~urt. rnd uupli..Nr ~.eth Tai Acucs~x)
BOJf ~O~ ''.1i.~ i~~5
_ i
- -
_r__ . -
_