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Declaration of Domicile and Citizenship
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TO THE CLERK OF THE CIIiCUIT COURT.
ST. L U~ I E OOUNTY. FLORIDA:
This is np deeluatioa d Domicile and Citisenship ie the State at Floe da that I am ~ this dy io aoootdanoe. and is
oonfamitT wits Section 22Z.1T. Flotilla Statutes. ^ n
• I was i~ a legal resident d ~,~~i (~-('~~tu ~ I
- J' Gay IG4l 18eai
resided st ~M~Qct~~~lLle'~
!t~ - However. I have ehangal nqy domieife to
I~wtadNrD~
and am a~ have been a boon Sde raddant d tM State d Florida sins ~ !e daT d
. lg.~.. and I reside st ~_S-'0 S~ ~C 1~•
~ , 18trat~Nesb~el
ST. LUG 1 E Cennti.
tabl
a~ this statement is to be taken as aqT deeLration d eitisenship. adnal legal reddeaoe aad domicile in tbs State d Florida.
• I f t'OR THE PURPOSE OF ENROt.I I Nf; I F FOR NOMESTEA~ PURPOSES
CHILDREN iN SCHOOL, PLEASE STATE PLEASE CHECKS
THEIR NAMESS
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1960 FEB -7 PM 31
FILf,Q
1?_NL PECOi~~
- ST~LwicR
SIT
- at:RK CIRCUIT
RECCIt01iERIFIE!?_-
I FARTHER CEATII~'Y that I wID register st sir local address when the registration boob reopen. and with aII
otter requireme~s d a legal resident d this State.
I
I F't1RTHER CERTIFY that I have no intention to return to m~ former door and I intend to remain is
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Swann to and subeaibsd batote me this dsT d
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RQGER P01 TRAS„ LERK OF' C IRGUt T COt~2T
~ ST. LUCIE COUNiY, L tOA -
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~ BY _ a ~
! EPUTY LERK ~'~e~
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