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Deciaration of Domic~le and C~t~zens ~p
~ .4' '63 ~
TO TIiE CI.ERK OF T1iE CIItCUIT COtIAT. .
ST. LuC I E _ oovrrryr, Fwnin~: ~
This is my declantion ot Dornjcile and Citizenihip in the State ot FbrWa that I am Cltng thL day ia uoordanos. and ia
eo~tormity with Seetioa 222.17. Fbrida Statutes.
I wu formcrl a legal resident ot ~lme 1 i a. - n?. ; r~ and I
Iqt~l l8tat~1
resided at ~ a Pi t~e ~,~Pw Dri ~r~? ~ a~t _ - Hoaever.I have ehanged ay? doia[eile to
18tn~t aad Numb~r)
and am and hava beea a bona !'ide nsideat ~ the State ot Florida sir~ee 2- 9- 7~~ d da7 ot
~
?eb. -19 ~~..andlresideat ~5~ Sc~li C'i rr-1p
(8tre~t ~d Nua~b~)
~ort St. L,•tcie, ST. LUGIE _ Count~,Florid~,
1CK71
illa ~I113 sLi~llpOQ~ 1! LO ~~Ql1 iS RlJ? dlCI~T~L~OA OI tJL1ZlIL1IIIp. actud kgal resideaee and domicik in the State of Florida.
• Ii FOR THE PUR_POSE OF ENROLLING IF POR HOMESTEAO PURPOSES~
- CHILOREN IN SCHOOL~ PLEASE STATE PLEASE CHECKS ~
THEIR NAMESS
Lisa P.e::ee Liql~t
~ ~~,;r~ R~CORDtD -
' Jel:~rey l~.rthur ~aht _ ' - ,.~V~;Tv FL.A-
-
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~ .433663
'79 FE~ 12 PM i: 13 ~
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I FURTNER CERTIFY that I we71 register at my local sddress when the registntion bod~e r~open. and comply .vith all - -
' other requiremenls of a legal resident of this State.
f
~
~ 1 FURTHE~ CFftTIFY that I have no intxntion to return to my fom~er domicile, and I intend to rema~n in
~ u~ _ COpQL~/,
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9
Fbrida. permanenti;.
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Gc~F COUC:SY ~ (N )
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~ Sworn o and subseribed betore me thu day ot
~
~ . A.D.19_ ~9 '
~
~ ROGER P01 TRA . CLERK OF C IRCUI T COl~2T
ST. LUGIE GOUNTY, f t,UA ~
8Ys ~
E P U T Y L C R K O R~03 ~AGE ~ V~
~OOK
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