HomeMy WebLinkAbout0866 D~ctaration of Domicile and L~t~zensn~p ~
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TO Z1tE CGERK OF THE CIRCUIT COURT. . ' • ;
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ST! LllC 1 E'~ t,pU~rY. FI,pRIDA.
Thls b my dec4ration o~ Domkile ~t+d CjtizensAip lA the Stale ot Fforid~ tt~t I am t~ing tAia d~y io aceordaace. and ie
coalormity with Section 222.17. Florida St~tute~. '
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t w~ io~ a kgsl reside~t ot - ~ _ ~ k~_, aed I
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resided at ! ~C~ t ~,~pC1,t S' e I~U . HoMrever. I Mve ehangcd my domicile to •
(StrMt aod NwoDK)
and am and i~ave beea a bona Gde re~id~nt ot the State of Florida since dar of ~
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,19 7~- and I reaide at
~ (Steret asd Nwnber!
~c~~2 /~.t a C~,`~ _ ST. LUG I E Count~, Fbrida.
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and this statemeni is to ba tskca as my decbration oI eitisen"ship~ attual legal residence and domicile ia the State ot Fiorida.
IF FOR THE PURPOSE OF' ENROLLtNG IF' FOR HOMESTEAQ PURPOSES~
' CHILDREN IN SCHOOI~ PLEASE S7ATE PLE/lSE CHECK2 ~
' THE1R NANES:
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FtLEO AND RECOROEO
ST. LUCIE COUNTr fl1
ROCER POITRAS
Ct~RK C~RCtItT OU r
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1 FURTIIER CERTIFY that I wil! register st my local addres~ when the registntion books reopen, and comp[y with sq
otber requiremcnts ot a Icgal resident ot this State.
` I FURTIIE~ CF.RTIF'Y thst I havc no iat~ntion to return to my former domiciie, and I intend to rems+in in
oL~i c i f ST UC 1 E . County.
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Ftorida, permsnentl~ , -
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5a•or~ to and suLsc~it?cd befarc me lhis day o( ~ ~ ~ r. ~
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ROGER P01 TRAS. CLERK OF C IRCUt T COU2T ~ ~
ST. LUG I E COUNTY, f LOk i UA • _
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EPUTY LERK ~
600K ~ PAt~ ~ .
' . AGO Farm 71 d ~i {
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