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46'7532
TO THE CLERK OF THE CIRCUIT COURT.
ST . L UG I E COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am Sling this day in accordance. and in
conformity with Sectioa 222.17. Florida Statutes. ^ ~ `
I was former! a legal resident of % ~/ki
ICitTI (State)
resided at . However. I have changed my domicile to
t and Numbsr)
a^d am and have been a boas fide resident of the State of Florida since i%LL't'2C.~ 1 ~ ~ day of
19~, and I reside at ~ ~ ~ ' f'v `
13trMt amber)
a,,,,/1i~ o~ ~ ST . Luc I E County. Florida.
Icscyl
and this statement is to be taken as my declaration of citizenship. actual legal residence and domicile in the State of Florida. -
IF FOR THE PURPOSE OF ENROLLING ~-IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOIr PLEASE STATE PLEASE CHECK:
THEIR NAMES:
i
1
'3'9 P~0' 29 i1= 14
FILED ~h[ ft lL:.:
SCLUCIE C~sVi Y.Fi.t.
ROGER POITP.,~S
~ - 9 ~
46'7532
j I FURTHER CERTIFY that I wi71 register at my local address when the registntioa books reopen, and comply with aU
f other requirements of a legal resident of this State.
i
~ I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
U C I E .County.
IC~ty)
Florida. permanents, .
-'c= + ,i.
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Sworn to and aubsrn~ed
before me this ~ day of / 'f- L'~--
Q 33yS~
e t/ M Q A.D.19_ ~ /
ROGER POI TRAS, CLERK OF G IRCUI T COURT
ST. LUCIE COUNTY, Fi_ORtUA
BY: ~ ~j'/~cc..Q~~
EPUTY LERK - .
BOOK 32i Pa~E 389