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Declaration of Domicile and Citizenship
44'710
TO THE CLERK OF THE CIRCUIT COURT.
ST . L UC 1 E _ COUNTY. FLORIDA:
This is my dedaratioa of Domiu7e and Citizenship in the State of Florida that I am filing this day is accordance. and is
conformity with Section 222.17, Fbrida Statutes.
I was formerly a legal resident of G f .AS is ()i U::: Y CCONi IECT I CiIT and I
I(.tit7) ISaate)
resided at 144 I IOLI.I STER ' :'AY , S .
. However. I leave ebanged my domicDe to
18treet and Numbed '
and am and have been a bona fide resident of the State dt Florida since 15 t h . day of
AIp 1979 and I reside at 924 D Sl1~lAN^'AS POI PT DRIVE
(8tnet and Number) -
I~C)RT PIERCi: ST. LUC I E County. Fb~a.
laty)
and this statement is to be taken as my decoration of utizenship. actual Icgal residence and domicile in the State of Florida.
IP POR THE PURPOSE Of ENROLLING IF FOR HOMESTEAD PURPOSES',
C'HILOREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES:
:gig Is '.r i l ~I~ ! I = 59
Alf.
f~ C11tt
444'710
I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and wmply with iU
other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have ao intention to return tom former domicile, and I intend to remain in
T. U C I E County,
l 1(tity)
! - -
~ Florida. permanenci; .
d
f
S_
_ T llmRk
~~OUNTyco ~
G
J==• ~ " t (Name)
sworn to and subsrn me this l ~ diy of ~~tl /~/dC~ f~OU~~ 33`f.5
0
T112~ 9 ~ -
ROGER P01 TRASL CLERK OF CIRCUIT COURT
i
ST. LUC I E COUNTY, f tOR 1 OA
BY:
. EPUTY LERK 1
3^(kir 3U~ ~lL 245 , .
.
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