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D~cla~atian of Dom~~~le ~n~ C;i~i~~:~~~~~~
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_ ST. LUCIE ^ _ ~~UUN"1'Y, rLO1t1UA:
Tl~is is my dcclaration of Uamicilc c?nd Cilizcn~l~ip in ti~c Statr of florida that 1 am tiling this day in
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accor~lancc, and in confonnity ~vith Scetion 2'_''_'.17, Florida Statutcs.
, c~ R rIF~ eY~ , and I
I~vas fonncrly a I~~,al residcnt of . ~s~,«~
(c~ir)
residcd at `TH~E'~ _ S i=_ Howcver, 1 have changcd my dotnicilc to
(Strrtl and Plumbrr)
and am and have been a bona lide residen[ of the State ot rlorida since day of
--~Fef'n~ t3F~f~__ , 19-~, and 1 residc at ~1Kx Pt•fl"f" t~;~_~___.~ ~ c~t l~~l
(Strccl and Number)
~~~1~F St . Lucie _ County, Florida,
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and this statement is to be taken as my declaration of citizenship, actual legal residenee and domicile in the State •
of Florida. . ,
(Inscri here any pertin~nt facts, such as s:+le of proprrly or businecss, nr relinryuuh~nent of em{+loyment at formet
domicile, removal uf famil, tu nr~~• dumic~l.. purchasr of hume, rtc.)
t . HOMEST~AD C~r1PTI0N:
ENTERING, CHILDRE.~I IN SCHOOL. ~
If entering children in school,
please list their names:
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i ~£RK L'ii:~.1l1? ~T ~ -
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~ 1 FURTH~K CERTIFY that I will register at my local address whcn the rcgistration books reopen, and
~ comply with all other requirements ot' a legal rrsident ot~ this State.
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I FURTHER CERTI[=Y that ( havc no intrntion to return to my fonner domicile, and I intend to remain in
b= ST. LUCIE
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L-~~i~-- - ~ , County,
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Florida, pcrmanently. <<`'~'~~ 4 David ber~ Youngblood
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fi `t ~:Y i
. . bctorc me this - ~
~ day of
S~vorn:~b'a1~il~s~~
i ~ r, ~ - - - A-n. 19__ 74
' ,~i iilg u ress
P.OGr?t P 7TP.AS, CI_FR?: CIRCUTT COURT , Florida
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~y Y~ Dep~.~ty Cler.:
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(Tu br r~i~ulcJ in duplicair atrJ uti~•in.d fJcd ~tiilh (.frtk Cir~uit C~•u~l.:~nd Jupli:alc ~eith Ta• As:e~•.~~~)
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