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514058 .
TO THE CLERK OF THE CDtCU1T COURT.
- ST. LUC 1 E ~pu~rry. ~t,pRIDA; ' .
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This is m~ declsration oi Domic~e and Citiaenship in the Stal,e oi Florida that I utn filing this da~ ~n ac~ordanoe. and in
coniormit~ aith Section 222.17. Florida Statutes. ~_ -
I w•as formerl a legal resideat of ~,1~ O v q~A S ,~t O S~ ~ and I
l~St~), ( t+1 -
m sided at ~-~' ~ ~ O'~ 4 ~ ~`~- C Ol `~ ~t11~ , Iio~rever. I have changed my domici'le to
(S•.reet and N~ber) ~ .
and am and ba~ e beea a bona fide resident of tbe State oi Florida sina ~~ di7 ~
-- ~ ~4 r1 .19_~I - and I reside at a ~ d~ ~~(~ W 1~ a- t
~s~c.~aN~~~
-~-~ - ~ ~ .~ ~ C~. ~. -~' ( ~ ' ST. LUG 1 E Count~, Florida,
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and this statement is to be taken as my declaration of ritizenship. ctual legal residence and domic7e in tbe State of Florida.
" IF FOR THE PURPOSE~OF ENROLLING
CHIIDREN IN SCHOOL~ PI.EASE STATE
THEIR N/IMESt
ve~R~ ~~j~~~Q ~ohr~rno/1
I F F'OR HOHESTEAO- PURPOSES~ ~~
PLEASE CHECKS ~
1981 JAN 16 PI4; 12~ 14
FI;<<~ eh( ~~(;Gk~ t ;1
S 1. LUCIE CCUN i Y. f( A_
ROGER f'CITRAS
CLERf( Cl3C~t! C~::r^,;, /~
'~n~.~ ~ . . ~~'~
514~59
I FURTI~R CERT'g'Y tbat I v~11 register at m~ local addr+ess ~vhen the_ngistration books nwpen. and compl~ ~ritb a]1
o:her requuemenb ot a 1ega1 resident of this State. .
I P'URTHER CER1'g'Y thst I have no intrntion to return to m~ ~ former domiu~e. and I intead to remain in
T. U C 1 E _ Count~.
- /(it~I .
F'io: ida, permanenti;.
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~ ROGER POI TRAS. CLERK OF C IRCUI T C0~2T
ST. LUGIE COUNTY, FLORIOA •
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BY: ~~
E~PUT-Y LERK
N~ARf'h~ ~A~le ~oh AN ~u c tit
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