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D~cl~r~~i~n of D~r~ic~l~ ~~d C~~«~nshi~
. ~ 4'T7139
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG I E CpU~Y~ ~,pg~A;
This is m,T declaration of Domie9e and (Stiunship in the State of Florida that I am filing taus dq ia_aocordanee. and is
oonformit~ with Section 222.1T, Florida Statutes.
I was forme a legal resident of R KE G 2C~ y E N ~ ~ and I
I9eaW
resided at ~ C S t~ N C u ~ c v (Z T .However, I have changed mJ domietle to
(sv«c and Nash b
and am and have been a bona fide resident ti the State of Florida since F : r s t" ~ ~
C~C~ ~o~r .19
~1~1-andIresideat 113 S.E• ~C2EE?~OO~ "~~F
(Stied aed Numb.el
70 cZT ST • L.u GS E. ~ ~ _ ST. LUG i E CountT. Fjord:,
tt~l
and this statement is to be taken as ml declaration of citizenship. actual Iegal residence and domica7e in the State of Florida.
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- IF FOR THE PURPOSE Of ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECKt
THEIR NANESS
'~Ot3ECZ"C ~CZ1C. ~AcR~(YNI~N
~vr
V ~T C2i Ci A ~ . ~Pta-z G N a- N
- - jocZT St. L~c~e~~,~..
33y5~.
I FURTHER CERTI>•'Y that I w9! register at aqT local address when the registration books reopen. and eompb with aD
Other retlt3lreme~a Cf i legal resident Of thla State. i
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I F[JRTHER CERTIFY that I have no intention to return to m~ former domicile. and I intend to remain io
~ . JT ~ L UC 1 E ~ . `~.OVnt~.
((St7i . _ - - -
Fonda. permanent!,,-. i
190 F~~ 26 30
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F tote ~r+c R= con,:t u
SLLUCtE C4UMTY.FL/~-
RQGER POITRAS
lLERi{ CiRCUiT CQJRT~
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~n1c`~v~vT 4'7"!139
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Sworn to aad snbseribed befort me this °Z ~O dad at_ 7~ 2T S L v c ~ e~ ~ l . 3 3 `t ~
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ROGER POI TRAS. CLERK OF CIRCUIT COtdRT
ST, LUCIE COUNTY, FLOR~oA -
a,r : ~t~ll~
EPUTY LERK
. BL'OK PIGE