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Declaration of Domicile and Citizenship
4'71`745
To THE cI.ERK of THE Cntcvrr covRT,
ST. LUC I E COUNTY. FLORIDA:
This is my declaration of Domiei7e and Citisenship in the State of Fbrida that I am filing this day is accordaaos, and in
conformity with Section 222.17, Florida-Sta~tut-es. D
I was former a legal resident of l o~ S / 1) ?f R Ne tci •TP ~ S e Y and I
(City) (Seat.)
resided at 2 A w T / 6t V A A t/ - - However, I have changed my domic7e to
~ (SteNt and Nuaabar) ;
and am and have been a bona fide resident of the State of Florida sinus 2 ~ d+7 ~
~Aw~ uA R 'I ,19 g o_ and I reside at 1 ti~ g N y t AA y ~ o A~
• 18eraat sad Numbs)
PORT ST. Luc/E ST. LUGIE ~ty,~;ds,
- latyl.
and this statement is to be taken as my dee4ntion of citiaenship. actual legal reaidenoe and domicile in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK(
THEIR NAMES!
~t L L
r
~'o N a ~ 1980 JAN - 7 PN 2~ 4 S
!
FILED ANO RECDk[x U
SLLUCIE COUNTY. FL A.
ROGER POITRAS 1
. 1:ltKll GINGUti CtH1Ri~ +
RECORD VERiFlED_~.._
4'71'745
I FURTHER CERTIFY that I will register st my local address when the registration books reopen, sad comply with all 1
I other requirements of a legal resident of this State.
s ~
~ I FURTHER CERTIFY that I have no intention to return tom former domicile. and I intend to remain in
' U C 1 E _ County.
• t
~ (City) ~
Florida, permanenci; .
e
t
I }
1
;
~,C'~_UY /f /
{'mo't . ~ , ' . C ' .C-~- c-( ~-~-eC~
~V ~ f
9 ~
PORT ST ~-yciE, FLo~P/DA 33'f5~
worn to and subscn'bed before me this ~ day of !
~ ROGER POI TRAS. CLERK OF C IRCUI f COC~2T
ST. LUCIE COUNTY, FLORIDA
sY: ry~,.,J~c~. ~ .
~ E P U T Y L E R K
• g~323 PEE 985