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Declaration of Domicile and Citizenship /
48~~'70
TO THE CLERK OF THE CIRCUIT COURT.
ST . L UC 1 E COUNTY. FLORIDA:
This is uU declaration of Domidle and Citiseaship in the State of Fbrida that I am 81ing this day in aooordance. and in .
oonfaarmity wlth Section 22217. Florida Stat~ut~es.
I eras former a legal resident of /y ~.S.~f~k'.~ ~ /y ~ and I
ICity) i8tatd
resided at . //i G~ ~ F 2~ .K~-rr~ 5 T" However. I have cDanged my domic~e to
18traat and Naaabar) .
and am and have been a bona foie resident of'the State of Fbrida since ~ ~ /l/' day of ~
r~q
y'4 ~uA~ ~ ,19~~. and I reside at / ~ ~G~ y S % -
~ IBtraat sad NombaH
7'" 9'/ s .e c ~ ST . L UC I E County. Florida. - . .
tav?
and this statement is to be taken as my deeLration of eItiuaship. actual legal reddenoe and domidie in the State of Fbeida.
'IF FOR THE PURPOSE OF ENROLLING IF fOR HOMESTEAD PURPOSESs
CHILDREN IN'SCNOOLs PLEASE STATE PLEASE CHECK:
THEIR NANE$:
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196 MAR 28 PM 2 09 ~
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I FURTHER CERTIFY that I w91 register at my local address when the regiatratioo boots reopen, and comply with all
other requiremeats of a legal resident. aI this S4te.
I FURTHER CERTIFY that I have no intention to return tom former domiule. and I intend to remain in
U C 1 E ~ qty,
" 1(St71
Florida. Fermanenu;
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Swoon to and snbsen'bed before me this day at _ f T f-~? £ C ~ L ~
r l ~ A.D.18.~.....
ROGER PO t TRAS, CLERK OF G I RGU 1 T COCd~tT
ST. LUC I E COUNTY f LOR 1 QA ~ ~
BY: - • -
" P L RK
B(Im~ JA.O P?GE
. ACOForm'll•71