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D~clara~ion Q~ Domicite a~d Ci~iz~ns~~ip
~ Si ~553
TO THE GLERK OF THE CIItCUIT COURT.
ST. LUC 1 E CpUIV'1~y, b'I,pg1DA;
~ 1
This is my declaration oi Domic~e and Citizens6ip in tbe State of Florids that I am filing this da~ in aaordance. and io
contormit~ aritb Section 222.17. Florida Statvtes. ~
I w as lornner]g a legal resident oi ~ v1 f. v r-e- - c ,~ 1~~i c, ~i P-l ;~~ ti•=r and I
~~ 1~t~1 I IStat~)
res;ded at ~`~ ~ ~~ v.~. ~r ~Y,~.~l` <~ ~ r_s ~xovvever. I bave ehanged nqy domia7e b
(Sueet aad Nomber) /
and am aad have been a bona 5de resident of the State of Florida since ~`~~' - ~j~ da~ at
- ` ~.r . . ~, - - 19 I `/, and I reside at ~ 7 ~ _~G'~ ~ I_ 1 i .:i ~ ~~.:' ~ '. ' `~
_, ~ ~ , (Streat aad Numberl
~- o v 7~ _ ~~ ~/ n; t4' ST . L UG 1 E Count~. Fiorida.
lCit7)
and this statement is to be taken as my declaration of citizenship. actual legal residence and domia'le in tbe SLate oi Florida.
" I F FOR THE PURPOSE OF ENROL~L ING
CHIIDREN IN SCHOOL~ PIEASE STATE
THEIR NAMESt
~
.~
IF FOR HOMESTEAD-PURPOSESi
PLEASE CHECK: ~~ .
~
1981 JAN -7 AI~ I I~ 27
F4EC tKt ~ECOnDi 0
ST.LUCtE CO~N1Y.ft A.
ROGcR POITRAS
CLEki( C~F.Ctl:T !'rl:j"~
N~CGi~"~ ~•~ ~ ~! ''_ 1 . q ~ -
v
5~ ~553
I FLTRTf: ~R CERTff'Y t6st I w~71 register at my local address when the registration books reopen, and eompl~ w itb aD
other requiremenb of a 1ega1 resident of this Stata.
I FUBT'HER CERT'IF'Y that I, have no intention to return to m~ lora-er domici7e. and I intend to remain in
y~ .-. ~ ~-: r k ~ c• ,~c- '~ ,-- 5T , L UG 1 E , CountJ.
l(St)) .
F'lorida. permanenci;.
COUpj .,'~
J~ & ~.~~~Tyo
V: , :G
o~: ~~ ~ :70
v` ~~~ : c~n
`rr ',. ;`=:i•_-.~ ; 'oe
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Sworn Lo and snbs~e~b~'6elon me this ~ da~ oi
~ ~~..~.~. .~.. / 98/
v ~ _
ROGER PO 1 TRAS, CLERK OF C I RGUI T COtdi2T
ST. LUG I E COUNTY, ftOR 10A •
• ~_
BY; C_~~e,,.,/_
~ ~~~
. CJEPUTY I.LERK
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BOOXc~~~ PAGE ~
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