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Declaration of Domicile and Citizenship
43449'
TO THE CLERK OF THE CIRCUIT COURT.
ST LUG 1 E -COU'NT'Y. FLORIDA:
Th4 4 rap decoration of Domidk sad Citi:ensbip is the State aI Florids that I am ~ thb dy b sooordanoe. sad b ~
oonformit~ with Section 228.17. Florida Statutes.
• Iwasiomer akgalresideAtat /Faycttevitler North Carolina ~I - L
• IQtll 18~~W F .
resided at 4102 Coven t r Road _ H~,~, I haw ahsnged W domic7s to .
(8t+wt aed Nus~r1
and am sad have been a bons Sde resident of the State of F7orWa since 16th ~ ~
February _i~79_~~i~ .2921 rtassey Lane -
tShwt ssd Nreb~rl
Port St . ~ Lucie ST. LUG I E . Counf,~. Florida.
~abl E
sad this statement is to be taken as ny? decoration of citizenship. setual kgsl residence and doa~iei7e in the State d Florids.
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IF POR THE PURPOSE Oi ENROLLING IF FOR HOMESTEAD PURPOSES,
CHIIOREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES:
Bryan Keith Combs - - t;
f 1LE0 ~~ND RECORO~~ . -
Scott Michael Combs S?. ~UCiE COUNTY: FI.A•:
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_ ~ 43,9'7
• Angelique I~'icole Yongue ~ Ss
- 'T9 f E8 ~ 9 PM ~ ~
.
CLARK C1P.C:3,T CpUR
I F'IJRTHER CERTI>!'Y that I will register at mT loesil address when the registration books reopen. sad oomplT with all
other requirenunb a[ a legal resident o! this State. •
I FURTHER CERTIFY that I have ao intention to return to m~ former doaun7e. sad I intend to ren~aia i~
i ~ ~~T ~ ~ ~ ~ c . CountT.
i i~71 _
Florida. permanentt; .
. .:::iiu~a,,,.
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Swore to sad subscribed before aie this -dal of _
. '19 ,~gsy
ROGER P01 TRAS. CLERK OF CIRCUIT COURT
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ST. LUGIE COUNTY, FLORiOA -
BYs
EPUTY LERK
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