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Declaration of Domicile and Citizenship i
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466413
TO THE CLERK OF THE CIRCUIT COURT.
St. Laicie COUIVI'Y.
` This h wy dec4ration of Domia7e sad CitisenshIp is tM State d Iorida that I am !flint this ds, to aoooedaoa. and is
eoaformity with Section 222.17. Florida Statutes.
I was forme Portsmoath New Ham shire
~7 a kgsl resident d P and I
ICk~I 18taeai
resided at 188 White Birch Drive However. I have chanted ~ domic~'le to
IStsMt ass Nsr~
and am and have been a bona tide resident od the State d Fbrida sins 1 dq d .
Janus ry i!~ and I ~ (Lot ~2~) Marathon Avemie
l8trr,R ast NsnDati
Port St. Lucie St. Lucie Coaaty.pia,ida.
1441
sad this statement is to be taken as nl1 declaration d eitisenship. actual kgsl residence and domieSe in the State d Florlds.
I am presently a member of the United States Air Force on active
duty and stationed outside the state of Florida; however. my permanent
home is now Florida and Brill be after ~Y retirement fran active
duty. The above information also applies to i4Y spouse. Patricia A. Shy.
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I FURTHER CERTIFY that I will register at m~ local address when the registration books reopen. and ~Pb' wftb all i
other requirements of a legal resident of this State. 1
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I FURTHER CERTIFY that I have no intention W return to m~ tosser domia7e. and I Intend to remain in
Port St. Lucie St. Lucie C~7.
ICk~) .
Florida. permaaentl)?. 466413
° 9 51
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ST. LUClE GGilMTY.~LA.
ROGER PdITRAS
CLERK CIRCJTi t0~1&F
William H. Sh
2923 Leawood Dr~~
tlnaha. NE 6812°""
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Swore to and subscn'bed before ms thL - _ _ daF d
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ifMfRAt ~OiAp~ -Silo N MN~+s.+
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