HomeMy WebLinkAbout0001 ~ Declarat~on of Domicil~ and Citiz~nship `t',
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TO TlIE CLEItK OF THE CIRCUIT COURT.
ST lUC i E ap~~ F~.ORIDA:
'1'ht~ V enr dcelaratioa ot Domicile and Cit~sceuhip in tM State o[ Florlda tba! I am Glias thb day ia aecoedance. and ia
~~i~~iY eri!h ~**ti±+~ ???:1~; ~lor~ds st~tuta~,
t wa [o~ crl~ a kgal resideat of - ~ I P n e n~ ~ ~ t~ t-o . n ~ T ~
. tCkr? 1
reslded at _ ~-~-1 ~ ~Q n~„ ~ Nowaver. I tuve chaaged oqr domicile to
ISte~«~t aed Nuwesd •
and am aed bave beea a boru Cede resideat ot the Slate of Flotida sinee ~1/ n ~i l~ ~jr ~
~ /V . FQd . /~w y ,
~ ~ ~ 19,.z,~,. aud I resido ~t - - ~ a / D ~ G o L n.~' ~ v ~e ve ~e~i.~~e ~ame
- f~, r- ~ ST. IIIG 1 E~••~••aN.me.r~ ~rk
Councy. Florid..
tCM11 . .
~ad this statenuat ~ to be laken as mr declaratlon ot citizea~hip. actud kgal resideeee and domidle in ths State of Ffo~ida. ~
If iOR THE PURPOSE OF ENROLLING IF FOR HONESTE-A~ PURPOSES~
CHILDREN IN SCHOOL~ PLEASE STATE P{.E/lSE CHECK: ~
THEIR NAMESS
_ ~a t re.1! Da ~o,~,~ ~ar~..~ ~
FILEO Ayf RECUR~EO
~ ST- Li1C1E COtiNTY fLA.
AOCEF POtTRAS
CIERK CiRCU1T tOURT
P.F~JRD YEP,tF~~Q
I~C 9 II OS ~M'16
~szo~n
I FURTHER CERTIF'Y that I ~?iq register at my beal address when the registratioa books reopen. and oomply wilh all
other requirea~ents ot a legal resident ot this State.
l FUftTNEit CE~TIFY tl~t 1 have ao iatcntion to return to my former dornieile. and I intend to remaia in
~f - i F i`c r _ ST. LUC t E ~County. '
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Sworn to ~nd subscribed betore mo thia day of
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. A.D.19 ~G - .
.fiOGER PO! TRAS,~ CLERK OF C IRCUI T COU2T
-"ST. LUC 1 E COUNTY, F ~OR 1 UA •
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' . E P U T Y L E R K dU~ PACE • 1
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