HomeMy WebLinkAbout1383 Deciaration ot uom~c~~e ana ~~t~zensn~p
TO TH~ CLERK OF THE CIRCUIT COUR~. 31S~~?g
ST. LUC i E ~p~~~ ~,p~p~; ~
This b m~r decuntion ot Domlcile aad Citiseaship ia ths State ot Fbrida tlut I am ~iliag this dqr ia saoo~danee. and in
ooniormity with Section 222.17. Fbrida Statutea.
I~ru fo~ a kgal resident ot N F~ Yd Q K ~•y aad I
resided at v~~ r Q Q' ~ l~"~'C 3 D , . Nowever. I Aave ehanged my domicile to
l8tn~t aed Nua~bKl ~ ~ • " I ~
•ad ~ra aad ha~ beea a boaa tide resideat ot tbe State ot F7otids sinoe `••C" da,~r of
T„ 19 ' ~ - aad I~
ej
t 7~ / ~.~JC S~D / r ~ ~ .
• f1 S O K , J( le~r..c+aaNameK!
~N S!i'N Q rc'~4C~f- ~ ST. lUG I E Couat~. Fforida.
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and thia statement is to be Wcea as my declantion oi eitizenshtp. actud kgal resideaee and danicik ia the Stata ot Florida.
If fOR THE PURPOSE OP ENROIIING IF FOR t10MESTEAD PURPOSES~
CHiLaREN IN SCHOOL~ PLEASE STATE ~ PLEASE CHECK: ~
THE1R NAMES:
' ~C~~ ' ` ~ ~ ~ FILEC AND RECOROED
ST.~UCIE COUNTY fLA.
CR I Sf
I~~ YI CT~~ _ ROCER POITRAS
QLERK C1~;CUIT COURT
RECORa VER+FIED
/~c,oL3 S/ c.u ~4~t^'~4 U N
_ S~ 8 !2 s9 PN'15
~ls~s
I FURTHER CERTIFY that I will register at my local addre~- !°~!_n fh~ raeiefr~tinn M..k: rP~n. and comolv with aU
other requirements of a legal resident of this State. • .
' 1 FL1RTIiE~ CERTIFY that I have no intrntion to return to my formcr domicile. and I intcad to rerosin in
i • , ST . L UC 1 E Counly,
~ (C~trl
~ }'lorida. permanea~i; .
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y Sworn to and sub~crbed betore me this ~ day of ~"''~e N 33~',
~ •
~ , A.D.19 7~
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~ R OGER P01 TRAS, Cl_ERK OF G IRCUI T COURT
3
~ ST. LIJC i E COUNTY, FLOR 1.OA
~ BY: _
~ E UTY L K
~
BORK243 PACE1~~ ~
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