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Declaration of Domicile and Citizenship
4'T763'7
TO THE CLERK OF THE CIRCUIT COURT.
- St. Lucie- COU~Y~ FLORIDA:
This is ~ declaration of Domidla and Citisenship in the State of Florida flat I am ftiHng this day in aoooedanes. and is
conformity with Section 822.17. Florida Statutes.
I was formerRy a legal resident of Forestville ~ Connecticut and I
(pRy) l8tat~
resided at f
`0 u°'~'~ Awad _However. I dove ehan8ed my domicile to .
18teed aed Nobel 27th -
and am and have been a bona fide resident d the State at Fbridasince - ~y ~
January 19 ?7 _ and I ~ 303 ~clid Street
Fort Pierce ls~wtadNmbsel
St . Lucie County. Florida.
and this statement is to bs taken as my declaration of eitisenship. sctnal legal residence and domicils is the State aft Florida.
- IggO FEB 29 t~h 11: I 0
_ nECUl+of-o
~~,~~PO~TRAS"'
CLERK CIRCW _
CtiU~"
a'T763'~
I FURTHER CERTIFY that I wRl register at my .loaf address wben the registration books reopen, aad comply with aU
other requirements off a legal resided at this State.
I I have no intention to return to my former domie~le. and I mend to remain in
~ - ~ .Port t. Lucie St. Lucie -
County.
(Qt7)
Fbrida, permanently.
~~Q~~ oJ°I`~
- tFlama l
2285 S. Midto~rn Rd.~ Pt. St. Lucien Fl.
~ lAaa~...l. 34 I
Sworn to and subscn'bed before me this ~ day aff _ti,;:?+~~uIrti;,
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Notary hbitic, 3Wa of i~ , vsS - Q -
My Commission expires . . ~g ~ic.`:`~ • .
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