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44i"7459
TO THE CLERK OF THE CIRCUIT COURT.
ST . LUG 1 E COUIyTY. FLORIDA: •
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance. and in
conformity with Section 222.17. Florida Statutes.
I was former a legal resident of ~ ~ k K~S ~q and I
ICit~? (State)
resided at / ? '~0 ~ ~ L CT . However. I have changed my domicile to
(Street aad Number)
and am and have been a bona fide resident of the State of Florida since a ~ ~ day of
/~0 t? .19.2. and I reside at 9 ~ ~ ~ ,~oa,ae/~ LyQ~t/,e.
(Street and Number)
PbR T- ~T. ~ ~t C i e. S T . L UC I E County. Florida,
lcany? -
and this statement is to be taken as my declaration of citizenship. actual legal residence and domicUe in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES, i
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK: ~
THEIR NAMES: -
F1lEQ RN[ Ff 3c ~ i
ST.llt'.:'lE C]:;`li Y.F:..
ROGER F'~ITRA~
i
~4~'7459
i
i
~ I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and comply with all
other requirements of a legal resident of this State.
f
I FURTHER CERTIFY that I have no intention to return tom former domicile. and I intend to remain in
' T. U C I E County.
i (City)
!
Florida, permaneati, .
!
_ . ~ !
• _r~
k _ -
i ' lh.me~
F 4
' Sworn to~ind subxn'bed before me this ~ day of /'V/CT S~ l ~ e ~ ~ -
E `~~DL~r ~rril~Jc' . A.D. 29_ ~1
E -
ROGER PO i TRAS. CLERK OF CIRCUIT COURT
ST. i E COUNTY, FLOR t A
BY: - c cQ1~
EPUTY LERK A -
{ 800K 321, PAGE 258 '