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~ 3~603
TO TNE Ct.t:RK OF TNE CtRCUIT COURT. ~ •
ST. Ll1C i E COUNTY. E'LORIDA:
. • .
Tbb ~s m.y deelantion ot Domicile and Cil'ucnship in the Stdte ot Flocida t~at Z am filing thu day in aceordancc. and ln
eonto~mit~ with Section 22?.17. Florida Statutes.
I ~ra~ lormcrty a legal reaident ot g~R~~`T ~~.~T . ~ and I
~ ICitrf ISat~)
resided at - ~ No~rever. I have ehaaged my domicik W
l3tr~et and NumDsr)
u~d am and have been a bona Cde reaident ot thc State ot Florida ~ince S~ • I c~ ~ I~ 1~ 1 e~ dar ot
S~`r • .,19 ~
~ and I reside at Z O "Z ~ ~4k~i06~ ,Q,~.
(Strwt aed NwnSer)
/~Z' ~ L U G 1~ ~ ST . LUC i E Cou4cy. Florida. .
. cat,)
and this statemeat is to be taken a.s my declaration ot citiaenship. uctua! legal nsidence and domicile in the SLate o[ Florids.
IF iOR THE PURPOSE OF ENROLl.ING If FOR HONES7EAD PURPOSES~
CHIIOREN IN SCHOOL~ PLEASE STAT~ PLEI.SE CHECK:
tHE1R NANES: ' ~ ~
fILEO ANO RECORDED
ST. ~UCIE COUNTY F~A.
• ROCER POITRAS
CIE~K CIRCUIT COUR~
. . .~~-4.CiED
~ DEC 1T i i n~ AH'~~
~ 388603
' I FU:iTHER CEF:TIFY thai I~•i!! register at my Irscal sddress wFeen the ngistratioa bw4:y reopen. and comply ki.h F!!
~ othr.r requirements ~f a legal msidrnt of tt~i.ti StaLe.
~
I FUF~1'EIE:t CERTIFY th_t I f:ave no inter.tio~ ta reiurn to my former c~oruiciie, and I intend to remain in
'('6 2T c~(-- l.V G j~ $7 e L UC 1 E ' Co~nty.
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Florida, p~:~cnanenci;.
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