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HomeMy WebLinkAbout0321 . D~c~aratian of Qomicile and Citizensn~p ~ , . ~ ' 414969 ~ • TO THE Ci.ERK OF TtiE CIRCUl1' COURT. . , ' : ~ \ ' I . 1• . ' ST. LUG 1 E COUNT'Y~ E'[.ORIDA: . ?nis u my ~~:~.:::;:.a at L*~^:!riir rit~r~n,hip ie tAe State of Flocid~ that I am tili~a thL+ dar in aceord~nce. ~nd in contormity ~ith Seetion 2~.1T. Florida Statutes. ; I was form~rl a lrgsl resident ot 8/~O O l~ G S/ ~C.~ ~/~G[/ L~~~ and 1 I~:u~l fSut~) rtsided ~t ~~~Sr ~~f r -S . However. I luve changed my domicils to - l8te+~t ~od Numb~eri / S and am and have been s bona Gde resident of t~e St*te of Florid~ since day ot ~ ~ ia~ ~ Ms~ae sc ~ ~e~. ~~',~,e~'1'1E-r ,r.~.c' . (sc~.e .aa Nameer) ~,f' ~ s T'` .-~cr~t/E ST. LUG 1 E Count~. Florids. ~ , 1Gt71 4 and this statement i~ to bc takeA aa my declaration oi citiun'ship. actual kgd re~idence and domic7e in the State oi Ftorida. IF i'OR THE PURPOSE OF ENROILING Ii iOR HONESTEAD PURPOSES~ CNII~REN IN SCHOOL~ PLEASE STATE ~ PLEASE CHECK: ~ • " TNEIR NANES: ST tUC E COUNTY fLA. ROCER POITRA . r_cPt i,14CU1T CO T ~ ~;Ed . ~ . , a~~r z5 3~ 6 P~ ~~s . 4149b9 I FURTIiER CERTTFY that I wiil registcr at my local address when the regisiration books reopen, and comply with all other requircments o[ a Iegal tesident oi Lhis State. I FURTIIE~ CF 1iTIFY that I have no intcntion to return to my former domicile. and 1 intend to remain in ~c~,~' .,f ~`c,.~i ~ ~ ST . L U C I E _ ~ County. - ~cu,,? . Florida. permanenti; . ^l~ C~Q:,IJ~~ t~ . ,*c = • • c_i ~ c~' ~/jt ir•`~ S ~ / ~ ' ~ ` ~ ~ ? ~ G~- LC- CGG ~ 4 ~ ~ ~ r ~J !~1! ~~7, ~ s ~ _ ~ ~ : y~ ' ~"i~~~~ X_ Cc~'c v/?CS',E' S1~3~~ ~N~.~ ~ .c ~f ,~i'.E'.r>1'1Ey C~.c' . (Address) . Svrorn to ~nd subscritrrd before m~ this 2 5 day ot ,~C%+~ ~-s7~ -~~-t''~ f ~ G~~ .3~~.1"e~ ~a v~~ . A.U. l9. 7 8 . / ROGER POt~TRAS, CLERK OF C IRCUI T COURT ST. LUCIE COUNTY, FLORIUA ~ Bv s .G(,t' . - . EPUTY LERK , , , ~ U k Z~ f1~~ Vi~ ' 6~0!( AGO Forn~ 7! . t• _ - - ~ .i_ ~ _ _ ~ . _ - - , ~ > . ~ ~ : . . ~ ~ ` . . ~ r~~`~