HomeMy WebLinkAbout0064 D~c~aration o~ vom~c~~~ d~~u ~~~~«~~J~..N
' • ~ ~14'7~1 ~
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~ TO TE[E CLEitK OF TNE CiRCUIT COURT. • . ~ • t.
' ST. LUC I E COUNTY. FIARIDA:
Tl~is is my dalantion oi Qomicile and Citizcn~hip in the State of Ftorid~ th~t I~m Cding thi~ daJr ia aecord~nce, ~nd in
contormity with Section 2~.17. Fbrida Statutes. ~ • '
l~ /'i/~ ~h1¢~andI
1 was torm~rl a kgal naident ot _ ,~~r~ "
• 7 v7 1 c~/ Howeve~. I have clianged my domicile to -
residcd at - ~ • -
(StrNt wd NuaOed .
dsr ot
and am and have been a bona C~de resideat of the Stete of Florida since
~'f Cl ~ ~v S~r ~v ~ ~k/~/I S %
_ 19 acd I reside at S~
Q~ ~~,r 4 t, _ ST . L UC 1 E County. Florida.
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and this statement is to be taken as my decfaration of citizenship. actual lrgd re~idente and domicile ia tht State ot Florida.
IF' FOR THE PURPOSE Of ENROLLING IF' FOR HOHESTEAD PURPOSES~
CHII~REN IN SCNOOL~ PIEASE STATE PIEASE CHECK: ~
• THEIR NANES:
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~ ~ ~ Fafo ~No aECOaoEO ~
~ ~ ST: WCIE COUNTY F~A.
~ ,t NOC£R POITRAS
C!.EP1~ ":RCUIT ~ R
. . __.F:EO
A{„ 2~ 9 4o AN'1B
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414'7i31
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` I FUBTIiER CER'~'IF'Y that I M•ill registcr at my local address when the registration books reopen. aad comply with all
; other requircments ot a Iegal msident of this Statc.
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~ I F TI3EZ CERTI~ that I have. no intc ntion to return to my formes domicile, and 1 intend to tem~in in
~ ~r7,~ . ~L[<<~ ~ $T LUC I E .County.
~ • ICitr1 .
~ Florida. permanenti;.
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~ ~ •c~FCQUS~TY.~~' (N~Me)
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~ Sworn to and subscribcd beforc mc t6is 3 day oI
~ ~ 3 y.~-~
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; ROGER POITRAS, CLEi2K OF CIRCUIT COlX2T
~ ST. LUCIE COUNTY, FI.ORtUA ~
~ ~ Bv: ~C~,c~ ~C~h ~ • -
~ _ EPUTY LERK -
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~ ~ ~U01f PACE
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- AGU F'orm Tl :
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