HomeMy WebLinkAbout0267 v~ctarat~on oT uom~c~~e ana ~~~~~c~ ~~N ~
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TO TNE CLERK OF THE CIRCUIT COURT. . ~ , ' ;
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~ ST. L UC i E CpUNrY. FI.ORIDA:
TAfa b my declar~tia~ 01 Domicile aed Cit~Qa~Aip in tAe St~te ot Florida that I am fili~g thls day ia ~ccordsaca. and jn
eonformity with Section 222.17. Fbrids Statutsa. ~
I was torm~rl s kgal cesident ot L ` C~- ~~~~'1' ~k ' ~"d I
ICit lSt~l
resided st ~Z a-~G~ ~ . Howeves. I bave chu~ged my domieile to • ~
(9tewt aad Nuivs0~r)
and am and hava been a bona Cde re~ident ot the State of Florida since _ 1~ a•y ~
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, / L
' 19~. and I reside at ! ~ ~ p'~ ~ ~ ~'T
(5tn+t aad Nwae.rl
,ti ,r , ~ ST. LUG t E Count~. Florida.
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and this statement is to be takea u mjr declaration ot citizen'ship. aetual legal re~idence ared domieile in tbe State at F'lorida.
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If FOR TNE PURPOSE OF' ENROLLINC .If fOR NONESTEAD PURPOSES~
tHIL~REN IN SCHOOL~ PLE/1SE STATE PLEASE CHECK: ~
• THEIR NANES: ~
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~GOY~T~ FLA.
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ROGER POiTR~S
C ~t _ ' Ct E°S ClR~~C COUR~
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41493d
I f'URTIIER CEIt1'IFY that I w~l.register at my local addres~ when the registntion booics reopen. and comptr with aU
other requircmcnts ot a Icgal resident ot this State.
1 FUEtT lEZ CFQT~FY that I have no intcntion to return to my former domicile. and I intend to remain in
~~tr,t.. e_ ~ $7 . UC 1 E - . County. .
~ lCit~! .
F'lorida. permancn~i; .
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P~Oy / GL-~n !/•I Gt ,r "J.GC'!/W" /i1 .
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Sw~orn to and subscrit?cd hetorc mc this ~ day o[ ~t ~~~~~'e-~- Q~a/ :
. A.D. l9. 7 ~ '
ROGER POITRAS, C~ERK OF CIRCUIT COU2T ;
ST. Ll1G t E COUNTY, f LO~~ 1 UA • ~
BY: .
. EPUTY LERK , ~
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