HomeMy WebLinkAbout0424 ~'~;:LeE~.~~"v3~[4~~D L~~.T~I~~C:i~C: e;~11t] ~~c.i~Ly~~i~~~..~
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TO THE CLERK OF THE CIKCUIT COURT.
ST. LUC 1 E ~p~•. ~,pRIDA:
• This b my declaration ot Domicile and Citizert~hip in the State ot Florida that t am Ciling tAis dar ia accordance~ ~nd in
contormity with Section ~.17. Florida 5tatutes.
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I~rat fo, rmCr1Y s kgal resident ot ~"Y' a 77 ~ l~c~l /b i~S ,'-l ~~~1 . and I
~ /J'~ lCit~l ' IStat~)
naided at _ ~ 4~ CY 1'' ~ a~'~ o ~S'F Howevcr. I tu~vs dunged my domicik to
Istn+t aad NumD~r! • ~
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and am and have beeo a bona fidc nsideat o[ thc State of Florida ~ince ~ 9 day ot
,d L~ e~» ~'6 ,19 7?. aad I reside at ~O cl f~? a.
~f ~r S~» ~ a c, f1 ST . L UC I Esen~t ~ trn~~1
. Countr. Florida.
(Ctc~)
aad this statement u to be taken u my de~laratioa ot citizen~hip. actus! kgal nsidence and domicik in the State ot Florida.
IP FOR TNE PURPOSE OF ENROLLING IF FOR NOMESTEAO PURPOSES~
CHIIOREN IN SCHOOI~ PLEASE STATE PLEASE CHECK:
THEIR NAMES:
FIlEO ANO REC4k~EG
ST ~~~~~a~ppITRAS`~
-.:cu~t coua' .
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I FURTHFR CERTIFY that I wil! register at my local address when the registration books reopen. and comply .vith all
~ other requirement9 ot a iegcl residenl ot thiu State. .
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~ I FURTHE:t CE thst I have no inttntion to retura to my fora:er domicile. and I intend to remaia in -
~ Y ~ S T. ~ U C 1 E . County.
~ ~ (Cit~) . . -
~ Florida. permanenci; .
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= Sw•orn to and suGscribed before me i~u _ / d day of '
- - - ~ A.D.19 ~
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- ROGER P01 TF2AS„ CI.ERK OF C IRCUI 7 CQU2T
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ST. Ll1C I E COUNTY, FLOR 1 UA •
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