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Declaration of Domicile end Citizens ~p
. 4+4Q19~.
TO THE C[.ERK OF THE CIRCUIT COURT,
St. Lucie OOUAITY. FLORIDAe
This is my declaration of Domicils and Citizenship is the State of F{ocida that I am fiUng this day la aeoordance. sad is
conformity with Section 222.17. Florida Statutes. i
I was formerly a legal resident of Hampton _ ~ _ _ Virginia ~ I
lCit~l 18tata) '
resided at z St . Paul Court ~ ~ However. I have changed my Oomkik to
(8tnet and Num~r) .
sad am and have been a bona Gde resident of the State of Fbrida since ~ day ~
~T7L W OOa _ .
~'4 Q L M .19~~. sad I reside at 1009 Gater.~,rDrive
18t»at sad Naa~rl
Ft. Pierce ~t. Lucie County.I:'lorida.
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and this statement is to be taken u nqr declaration of citizenship. actual legal residence sad domicile in the State of Fbrida.
F1LE0 AND RECORD~Of ,
! UCtE C AUNTY FLA.
440191
. 'Z9 A°R 9 AM 9:16
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I Ft1RTHER CERTIFY that I will register at my local address when the registration books reopen. sad comply with all
other requirements of a legal resident of this State.
I FURTIiER CERTIFY that I have no intention to return to my torakr domict7e. and I intend to remain in
Ft_ Pierce ~ St. Lucie .County.
(Cityl
Florida. permanently.
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Sworn to and subscribed before me this ~ day of • ~ N "
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7 At~t S~aN G. rl~ ~ 1..L r ~ ~ pt~ u W ~ p _ _ 2~
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My Commission expires 1O J s C - e.;
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i? 306 -1749
~ - AG(f Ferm 7S 72
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