HomeMy WebLinkAbout0001 Declaratior~ of Domicile and Citizenshi ~
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~ TO THE CLERK OF THE CIRCUIT COURT. . ' ' ~
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~ ST. L11C ! E QpUNTy. FL,pRIpA:
This ts mr dcclarstion ot Domlcile and Citlsenship [n the State ot Flocida that I am filing this day iti aecordance. and ia
contornnicr with Seetion 222.17, Florida Stacutes.
I was iormerly a kgal resident ot ~~1L~,:;~1~'.~~L~~ , `j ~ o fi'~~' and I
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resided at ~ s~E'~~~ ~-t~ t . However. I have changad rnp domicile to ~
l&rs~t wd NnanbK)
and am and have been a boaa tide reaident ot the State ot F'lorida sit?ee -S~ day o[
19~ aad I resids at L' ~~oSr t'~ T
(Stn~t and NnmD~e)
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/~C,e T S%. ~ ST , l UC I E County. Florid~,
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and thit statement i~ to be taken ~s my declaration ot citiren~tip. sctual tegal re~idence and domide in t6e State o{ Florida.
If fOR THE PURPOSE OF ENRO~LING IP iOR HOHESTEA~ PURPOSES~
CHILOREN IN StHOOL~ PLEASE STATE PLEASE C~HECK: ~
' TNEIR NAMES:
,b e ~7`- /'~-~.~i ~.c~v
F LED ANO RECOR~EO
E~.lUC1E COUNTY fl~t.
ROCER POITRAS
' Cl~RK C~RCUIT C UR
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Auc 8 3 4~ PN'18
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I F[JRZ'FiER CERTIFY that I w~! register at my local yddress when tbe registration books reopen; and complr with sll
otber requiremeets ot a legal resideot ot this State.
I1~~tTHE,ii CERTIFY that 1 have no intention to teturn to my lotmer domicile. and I intend to remain in
sr- ~ G~-i~ , S~,. Luc i E _conuty.
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Florida. permanenci; .
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Sworn to and subscribed before me this o day o[ '
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~.~n . A.D.19_ 7 ~
ROGER P01 TRAS,L CLERK OF C I RCU 1 T COURT
ST. LUG 1 E COUNTY, f LOR 1 UA
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EPUTY LERK- P~~~ ~ ~
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