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®eclarati~~ of Qarnicile an+~ CitiZensilip ,
4~'4~'99 ~ ~ .
TO TH>s CLERK OF THE CIRCUIT COURT.
ST. LUCIE OOUNTY. FLORID/b .
• ~ Thb b uo,F dee4ration d Doonldls and (~tisenahip in the State of ~oeid+? that I aAS 111>eS thin ~1T is aeoosriarrea. sod i•
_ conf~T with Section ~8.1T, Florida 8tatutee.
I was i a leSal resident d ~ ~~~Cte
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resided at 24 ~ Hun t Ne j„gh t s Dr iyg _ gOwelret, I T~ ~ doe3eSe ~
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and aaaand bawbees a bo+aafide rssideAt d tbeState d Florida ainee - 21st ~ d
September ~ ;19 79 -andlr~saidest 5~5 S.E. Fa~Ilon brive
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Port. St. Lucie. St..Lucie
and t1,is statameat b to b. takao se m~ dsdaratfoa d dtiseaship. aetnal ~ rasi~enei and doeadia b the State d Florida.
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- ~ REC0R9 VERIf1E0
- 4'74099
I FUATIIER CEATIFSf that I will register at nq local add:eaa when tha registr~iaa boob reopen. aa~ ~ with a>t
other requirements o[ a legal :+eadent d this State. ~ .
_ I FZTR'I'IiER CERTIFY tbst I have oo intent3an to return to aq? farmer domia7e, aawl I iater+d to r+ss~aia is
Port fit. Lucie ~ ~ St. Lucie ,~y~
lCttil
1.7orida, permansntb. - -
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565 S.E. Fallon Drive
Sworn to and subeas'bed before me this ~-s dad d Port S t . Luc le , FL 33452
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