HomeMy WebLinkAbout0442 Declar~~ion of ~ornici~~ a~~d Cit~zen~~ip
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ST. LUCIE - - ('UUN7'Y, I~LORIUA:
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Tliis is my d~•claration c~i~ Uomicilr and Citizrnship in thc Stat~~ of l~lorida that 1 am filin~; this day in
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acconlancc, <<n~l i~i conl'ormity with Srction 222.17, Florida Statutrs.
I was forn~crly a lcg.il r~sid~»t of ~J~1d.~L1_?~,~.~_-- .-/~.~cJ and 1
l~'~~Y1 (statc)
~r~idrd at ~2.~___~-CU/~n. -/4~--- ._Ilowcvrr, 1 h:~~~c ch:~ngcd my domicilc to ~
(Strect and N~nnbrr)
and am and h.~ve be~ a hc~i~a fide rrsident of thr St.~te of ~lorida since day of ~
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f (Siteci and lvumtK~)
Luc ie
4t~~-~-~---- --SL' County, Fl~~rid~,
(City)
::il(I 1~iIS SI:ItCllll'lll IS 10 t)l` takrn as my declaration of citizenshi~, :?ctual lec~al residence and damicile in 1he State
uf f~lorid~. ;
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(Insert hrre any prrtin.nt f•rcl~, such as salr of pruprrty or bosiness, or rrlinyuish~nrnt pf employment at fotmet ~
dumicilc, rcmoval of lam~ly to ncw Jomirilc, purchur of humr, rlcJ
I:~:'CE~IP<G CHILDRE`~ Iti SCHOOL: ~ HOMCSTFAD L?CEMPTIUV:
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lf ei~tering children in school,
~;lease list their narnes: 3~~06z
fIlEO ANn RECORDEO
St.IUC!E COUNTIf FLA.
ROCE~i ?Ot1RA5 -
CIERK CtRCUI? COURT
RECOFO VER~FIE~..~.-~--- ~
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~ 1 FURTlIL.R CI::ZTIFI' that I~:•ill rrgislcr at my local address ~vhcn thr rcgistratic~n boo{:s rcopcn, and
~ ru»>~~I~~ v•ith all oihrr rcq!~ircmcnts of a Ir~:~l resicirnt ~1'tllis Statc. ~
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~ I FURTIif:R CI:lZT~ll~Y th:~l 1 ha~•c na intc:~lion to return to my fonncr domicilc, and 1 inicnd lo r~main i~~ ~
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_ SIGi3A`l'URE---------- -
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_ SWOr.n-tn:aE~d_siFl?scribed bcfc~n m~~ ~~iis clay of
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ROGL:R POITRAS, CI.L'RK CIRCUIT COUR'f ~j S.~ ~ r~f , Flori~la
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_ ~~r a.~,~.c,G "~~-t,l~~ Deptit.5- Clerk -
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(To bc rcccutrJ in du~~liratr :~nJ ori~in:~l filyd ~~ith Cl~rl~ ('ircui! Cuurl, anJ 1I11~~I1~"IIC N'1'h l~~ A»c~r)
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