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Declaration of Domicile and Citiaenshi
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TO TI IB CLERK OF THE CIRCUIT COURT, '
_ ST. LUC 1 E (;OU~y~ FLORIDA:
This b my declaration of Domicile and Citisenship in the State of Florida that I am !iL'ng fhb day in accordance, and in
conformity with Section 222.17, Florida Statutes. ,
I wu t
rgsme_r~l
r a legal resident o: ~M ~ert2. and I
tCityl lstat,)
resided at . Howrever. I have changed my domicile to
1Stee~t sad Nwaba)
and am and have been a bona Cda resident of the State of Florida since ~ day of
.19 61 , and I reside at ~r~~ ~1 m I~r~ v~
• 18ti.et and Numb.d
_ Fort Pi~1~ y ST. LUC I E County, Florida, .
ICit7l
and this statement is to be taken u my declaration of citizenship, actual legal residence and domicile in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF iOR HOMESTEAD PURPOSES
' CHILDREN IN SCHOOL, PEASE STATE Pt.EA3E CHECKS
THEIR NAMESS
~il~ REGORGED
. ' f r Uri-v ~ ~
440546
'79 }~f ~ ~ 12 AM 9:44
- ~ 9~
I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and comply ~ritb all
other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return tom former domicile. and I intend to remain in
_ U C 1 E _ ,County,
ICn~)
! Florida, permanenti;.
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~CpUNTI- :
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`G~~El:ou?~SV-F~cQ~ 4~IOS Art~~clz. F~l.?~ (~r..aC:
~ IAdd,e.s)
::~~orn to and sn ribed before me this ~ day of Fart Perms + Floe
~cla
j
~r~~ A.D.19_ ~9 i
ROGER POI TRAS. CLERK OF CIRCUIT COURT
r
ST. LUCIE COUNTY, fLOR1UA
BY:
EPUTY LERK
' ~ - bo~i306 P~~2341
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