HomeMy WebLinkAbout0894 Decl~ration of Domicile and Citizensi~ip
.
. . . . . ~ ~
~ ror~ne cc.~x~c oF~ cu~currcovKr. 366438
ST, LUG 1 E ~p~t. F~pRtpw;
TAts b a~ de~daratioa ot Domicile aad Citisanship ia tM Stat~ o~ Fbcida tlut I ua GBai this da~ ia acoocdane~. and in ,
~oa~ora~ily t~?itA Ssetioa 222.~T. F{orida Statutes. i
. ~
i.rs. r~. ~~~c ~c C~ i F 7~a N~i~ R K ~ .aa t ~
tav~ «
raid~d at /.t7G L~ /4 VF, - Ho~w~w~e. I luw el~anaad aqr domieile t~o ~
1Ste~R ~i N~s0~t1 '
u+d aaa sad baw beea a boaa Cd~ resideAt ot the Stat~ oI Fio:ida sine~ dar o~
~
l"~R .19 aad I nsW~ at ~ 90 1 v~•v,~oF aR.
~ ISeeMt atl Nw~b~t
~a 1PT ~'T _ 1, ~ e ~ r_ _ ST. lUC 1 E ` Couoer. ~toriaa.
caa~
aad tl?b statemeat b to be takea u my deelarstioa ot dtiunship. aetud kgal raideaee aed d~e in t~e 3ta~e oi Fiorida• ;
~
IF iOR THE PURPOSE OF ENROtLINC Ii fOR HOMESTEAO PURPOSESi
CHiIOREN IN SCHOOL~ P~EASE STATE ~~EASE CHECKS
T H E i R N A M E S: ~ j~•--'-'~
;
. ~
• • FfLEO ANO RECOROED
ST. LUCIE COUNTY FIA.
~ ~ ~ . tiOCER POITRAS .
~t'K CI~CUIT COURT
- ~ ~IF'IED
~
~ - - - ~
. - 1~?18 I 3~ PN'~T ~
~ 366438
~ I FURTHE~i CERTIFY that I wn71 register at mr bcal addres~ wbea the segistration boo0~a reopen. aad camply witA s!!
~ other requiremenb ot s kgal resident o[ this State. - .
! 1 . -
I ~ CERTIFY tlud I have no inteation to return to my lormer domie~7e. and I intend to renuia ia
o~ T 5 T, 3. v C t t S T. L u c ~ e , Councy,
~ . . . z
Fbrids. permanentl~ .
;
s
_ . 's
t
. :
_ ' ~ <i'~
'~;i .~'c:..'~~ -
. ` ` ' • ~ : ~ w
. ~ _ ~
,s:.
• F p•' '
. . Ei ~ / - ' _ . i
I • ~ / / / ~
~ s'~r,' C a. ~ ~P~LS~I ~1 i W ~
• , am~ ~
' ~ ~ / ~ ~ ' V~/` ~ ~ n
~ ~ ;
~ Swora to and subscribed bc[oro me tAIs 1_Q_.._ dar ot ' ~
- ;
. ~
~ ~.n. i9 T~- 3~ S--~ '
~
ROGER P01 TRAS. CLERK OF C IRCU{ T COt~2T '
ST. LUG I E COUNTY, f I.OR 1 UA ~
~ B,r: ~ • ~ ~
- , EP LERK O R ~r~E
. . aeeK
'
AGQ Form 71 '~~2