HomeMy WebLinkAbout0226 . D~ctarat~an of Qannicil~ and Citizenship
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TO Tti~ CLEEtK OF THE CIRCUIT COURT. • , ~ :
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~ ST, LUC I E ~p~y, ~,pRm~:
~Thb is any deelaration of Domicib and Cit~cnsl~ip in tl~e State of Florida that I am filinq thla da~ In aeeordaaee. and in -
eonformitr with Section 2~.1?. FMrida Statutes. ' ;
I ~?aa [orm~rlY a kaal reaidcnt o[ ~-/,,,r, ~nd I
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residcd at ,y~ s~ ~~~'k,E~~~_~_ . However. I have changed my domiciit to •
l9ti+~t aoA Numb~rl ~ /
and am Md 1?avc beea a boaa C~dc reaident ot the State of Florids ~ince ~~~Q ' dir o1
~ ,19„~,~ aod I raide at / ' ~ ~?lo~ %
~ (Stc+~t ~ad NuroD~l
_ ,~,ti.~~ ~ ST. Ll1G I E County. Florida.
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•nd thu statemeat is Lo be takea u my dcclaratan ot citizenship. aetual legal resideace and domicile ia the Stste oi Florida.
If F'OR TNE PURPOSE OF ENROLLING Ii FOR HOMESTEAD PURPOSES~
CHIIDREN IN SCHOOI~ PLEASE S?ATE PlEASE CHECK: ~
' THE1R NAMES: -
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.~i~ciE cOU~TY $u°? .
. ROCER POITitAS
^tf FR r t;CUIT CO T
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I F'URT~IER CEIiTIFY that I~rili register at my local address when the registration books teopen, and comply with sU
otAer requircme~ts oi a legs] resident of this State. .
1 FUR lE;~ CF.Ii lthat I have ta inte tion to return to my former domicile. and 1 intcnd to remain in
ST . L U C I E , County.
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Fbrida, permancn~i; .
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'Cit~,. :
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Sw•orn ta and suLscriM~d beforc n~c this day ot t i' ;
~ ~.v. 7 8 ~os 7~ 2 ~'A~TI-! ~F _
ROGER P 1 TRAS. GLERK OF C IRCU1 T COU2T :
ST. Lt1G I E GOU , f l.Ok i UA •
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BY: ' ~Lc,t~,,/ ~
EPUTY LERK ~ ~
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. ACO Form Tl . _
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