HomeMy WebLinkAbout0837 Deciaration af Domicile and Citizenship
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TO T11E CL~:RK OF THE CiRCUIT COURT,
sT. ~uc ~ e courrr~r, ~t.o~un~:
TAis is ~rq? decuration o! Domicile and Citizeaship ia the State ot Florida thAt I am C~ling this day in accordance, and i~
eonlormity with Section 2?2.17. Florida Statutea.
I was tormcrl a legal resident o[ and I
tcur~ ~s~'
nsided at ~ ~ ~ ~ ~ ~ ~ - . However. I hsve changed my domicik to
(3tnet iad NYmEsr)
and am and have been a bona Gde reaideat oi the State of Florida since ~ day oi
1 19_~.. and I reside at 1~~ l p Lk' ' ~
(Stewt sod Number)
ST. LIJG I E
~~T_ `e~ e~, ~ County.Florida. .
(Cit~l 1 •
and this statement is to be taken as my declaratioo ot cilizenship. actud legal residenee and domicile in the Statc o[ Florids.
If POR THE PURPOSE OF ENROLLING If FOR HOMESTEAD PURPOSES~
CNIIDREN IN SCHOOL~ PLEASE STATE P~EASE CH~CK2 ~
tHE1R NAMES:
~~e(~ ~ CY~i~ i~. .l M
t LEO AMO RECaR0E0
LUCIE COUNTY FIA.
lIOCER POITRAS
c~ ~RK C~RGUIT COU
. . -r-; ~ ~"a,FiEa
Auc I~i I oz PM'18 J
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I FURTH~:R CERTIFY that I will registcr at my local address when the registration books reopen, and eomply with all
other requirements ot i legal resident ot this State.
i
~ I FURTI~E.~ CERT Y that I have ao int~ntion to return to my formcr domicile. and I intend to remain in
~ ~p~ ~ ~;Q~~ ~ $T. LUC 1 E .County,
° (Cit~) .
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? Florida. permanenti;.
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4; Sv?orn to and subscribed before mc this ~ day o( ~%'~lJ ~l
4 Q~~-~" . ,c..e~.-et , Stvr~.
~ A.D.19. 7 8 ~ ~ . ~ ~
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~ ROGER POITRAS, CLERK OF G IRCUI T COll2T
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ST. LUCtE GOUNTY, FLORIUA ~
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BY s
~ EPUTY ~LERK
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