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Declaration ~f Domicile and Citizenship
514028
TO THE CLERK OF THE CIRCUIT COURT.
St. Lucie
COUNTY. FLORIDA:
This is my declaration of Domicile and Citizenship iA the State of F7orida that I am filing this day in accordsnce. and in
conformity with Section 222.17. Florida Statutes.
I was formerly a legal resident oi Charleston W. Va. and I
ICit~) lStat~)
resided at 2918 Noyes Avenue . However, I have ehanged my domic~e to
(Stree~ and NumDer)
and am and have been a bona fide resident of the State of Florida since 15th day of
October 19 80 , and I reside at l,i_? Th nk~ai v? nq. AvenLe
(Street and Numbet)
Port St. Lucie . St. Lucie Couaty.Florida.
ICit~)
and this statement is to be taken as my declaration oi citizenship. actual Iegal residence and domicile in the State of F7orida.
1951 J.!.`~ I 6~': 1 I~ ~ 4
FI; ~C th[ FFCGr'.i~: Q
ST. L~C.iF CC:1!! i Y.1 l~.
ROGER PCITRAS
CLEkN CIRCUIT CCi:RSO
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514U28
I FURTHER CERTIF'Y that I w~71 register at my locat address when the registration books reopen, and comply with all
other requirements of a legal resideat of this State.
I FURTHER CERTIF`Y that I have no intention to return to my former domic~7e. and I iatend to remain in
~ Port St. Lucie . St. Lucie County.
(Cit~) .
Florida, permanently.
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. -~.. 112 hanksgiving Avenue
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~~f~ •Y ..H~.• .,,' ~ 1{~IIL SiAiE Of KORIQA A1 L/~'~E
~, _. wR.t~r '" MY ~MMISSION EJVIRES~ J1i~E 1 19i2
M7'~_,„yf -.~ne~cpites . wR1~
ITo be e:eeuted ia dupliute and origin~3 Gled with Clerk Cireuft Court, aod dupliute wilh Tu Aa~eswr)
~ B!1~K346 P~~E2865
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