HomeMy WebLinkAbout0959 . ~
~ ~~c~~rati~~~ of l~Qrnrci~~ and C~t~z~r~5~ip
a .
TO T11F. CI.ERK OF 9'llE CIRCIiI'f COURT. •
ST . L UC 1 E _ covN~~. FLOIiIDA: '
This is my dcclaration ot Domicite and Citizenship in the State of Florida thal I am CiGng this day in secotdance, ~nd in
conlormity with Section 2~:1?. Florida Statutea. '
I was form~rly ~ legal resident ot j /~'-x~ - ~nd I -
lCitrl " (SUtel
resided at ~ . Howcver. I hs~ e changcd my domicile ta
(Street u?d Number) .------_-_.r
end am and have been a bone fide resident of the Siate of F'lorida since day of
.19 . and I teside at ~ 3 ~ ~ O ~ -2- ~ ~ -
(Strest and Numberl
° ~ ST . LUG I E County. Fbrida. .
.
~a~,~
and this stnlement is to be taken as my declaration of citiaenship. actuat legal reaidenee and domicile in the State ot Florida.
IF FOR TNE PURPOSE Of ENROILING IF fOR NOMESTEAO PURPOSES~
CHILOREN tN SCHOOL~ PI.EASE STA7E PLEASE CHECKI ~
THEIR NA~IESt
sT. lUC
E COUMTr ~~A
ROCER POITRAS
z ~j ~aX ttRCU1T CO
- - rr, Y~ H~FIE~ .
A~~ r8 ir ~S aN ~1'~
40038~ ~
I FU1tTIlER CFRTiFI' that I will re},rister at my local address when the registration books reopen. nnd comply with atl
otfier rnquirements ot a legal resident ot thi~ State. -
I FURT}IE~ CE TIF'Y at I havc no intrntion to return to my former domicilc, and I intend to. remain in
' --~i~- ~E'~f.P~ , $7 ~ L UC f E . County.
(Cit~) ,
F'lorida. pcrm3nenti,.
UNTY c -
1t~`}4""~~~`~~ .
s~
C~ . ' ~ V~
d~ ~~o
J
~~c ? f`~ //l , -
'~~w~E co~
. ~ i o ~U
INune}
(Address)
SK•orn 1~,:~n~i sub:crih~•~1 hrforc me this _ day of
A.1). l9_ / ~
^l ~
RO('~E"R f'_ i TR
^.S, C!_FRK OF= C I_RC U t T COt~~ T
~1'. 1.:1~ i F C.GUNTY, F t(~?t ~!)A
f~Y:
Ei'tlt 1' ~LCfth ~
~
S~X ~ '
f
~ . .+1 ~ . .