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Deciarat~on of Domicile and Citizenship
480282
TO THE CLERK OF THE CIRCUIT COURT.
ST . LUG 1 E COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance. and in
conformity with Section 222.17. Florida Statutes.
I was former a legal resident of ( P'~ Y T,~ ~ C.' ~ and j
f.~
((S?7) ~ ~ 13tatE?)
resided at l~~ ~ r ~ y f - . However. I have changed my domicile to
ISe»at aE~d NamDEw)
and am and have been a bona fide resident of the State of Florida since ~ /~.Z ~ ~ G
~ ~y ~
.19_____., and I reside at l q~ /V. ~
~ Ip f~
(SwK and NEUE4bR)
. S T. cues) ~~f f= S T . LUG ! E Cooney. Florida.
and this statement is to be fatten as sty declaration of citizenship, actual kgal resideaee and domic7e in the State of Florida.
J"If FOR THE PURPOSE Of ENROLLING IF FOR HOMESTEAD PURPOSESa
CHILDREN IN SCHOO~~ PLEASE STATE PLEASE CHECK:
THEIR NANES:
~9so ~ Zo ~ r ~7
_ FltE-Q A C REC0~0
S~ LuuCI Cpp~~NTY. LA.
_ ROGE~ POIT AS
Ct.EtT)c CIACU)T C~~T~
Ai1001111'ERtFtEa_~
4~Ib2l~2
I FURTHER CERTIFY that I wIIl register at my 1oea1 addras when the registration books reopen, and oomp~y with all
other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return tom former domicik, and I intend to remain in
_ U C 1 E .County.
• ICRS) _
Florida, permanenti; .
COUNTS,
~LEIiS O_
sworn toand-su me this d ° day of , ,~.a-~''- ~ - ~ ~ ~ -
- U~/ ~ A.D.1~... wi ~I%RM ~ /yi I~S
ROGER POI TRAS. CLERK OF G IRGUI T COC~tT
ST. LUCIE COUNTY, fLOR1DA
8Y: ~~~.u~
EPUTY t.ERK
B00 c~ f PJ~CE ,
;r;ll Fr.-m 7i