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HomeMy WebLinkAbout0346 vec~arat~on or u~micii~ ana ~~~~zensnip u' 41Ei`79~ TO TNE CLERK OF THE CIRCUIT COURT. ST. LUC 1 E CpUN'Py, FLORIDA: . i This i~ my declaration ot Domicile and Citiscnship in the State of t'lorida tAat I am filing thi~ day in accord~nce~ and in eontormity with Sectioe 271.1T. Florida Statutes. ' ~ 1 was (ormerl a legal resident ot s~ . , 1~") c~ _ and I (Cit~) (Stat~) resided at .3 c_m~ ; rw.D~r~ However. I have changed my domicile to (3tre+t and NuoMr) aad am ~nd have bcen a bona fidc resident ot the State o[ F'lorida since ~ day ot r .19Z$.. and I reside at ~ L j } r ~ _ H ~ ' : ~ c'7 (sereec Number) ~i. 'r ~ ST . L UC I E Couaty. Florida. lcn~l and this statement is to be taken as my declaration of citiz~nship. actual legal residence aad domicile in the Stute of Florida. IF FOR 7HE PURPOSE OF ENROLIING IP FOR HOMESTEAO PURPOSES~ CHIIDREN IN SCHOOL~ PLEASE STATE PLEASE CHECK: ~ THEIR NANESI ~ • ~~~j ~ 4 V' ~ _ ~,~[>>1,~% v ~ fILE~ RN~ RECOROEa . ST ~uC~E CouM1r Ft~ ROCER PO~T~+~S CIEpK ;'~CUIT C ' 4 - • cr. SF~ 12 12 2o PH'78 41fi'794 ~ ~ ~ ~ ~ f 1 FURTNER CF.RTIFY that I will re~,rister at my local address when the registration books teopen, and comply wilh all ~ oiher requirements ot a legnl resideot ot thi~ State. - ~ I FURTEIE::t ('E:RTIFY that I have no intrntion to relurn to m[ormer domficite, and I intend to remain ii~ € _ , T U C I E . County. ICit~l . Florida, permanen~i; . s ~ ~ ~ - ~ ~ ~ ~ COU~ylr ~ ~J:: = :c~o ? ct: =;G ~ ~ U ~ : ~ j • i ~ ,r-~ ~ cr-~i Z,,; ~ -.t.- ~,,''=._o- ;,:'~r (Nune) iP~: ~ s ~v`~~ 1 ~F~'~P~ ~~I ~ ~-s~~'=-=~=~ - '~r';: 't. 'ht;L'~.~v.~~ n _ (Addrosal Sw•c~rn to and ~uhscribe•d before m~ this _L_ day of f.~.t-~ .y ~ , ; , A.U. 19. 7 8 ~ ROC,ER POI TRAS, C~EF?K_OF _C IRCUI T CUtk2T ~ • ~ ST. LlK 1 E COUt~TY, F ~OZ 1 UA :ti ~ aY: ~ ~EPUTY ZLERK ~ . PAGE 346 ~ ~ F 294 ~ ~ ~ :y At:O Furro '~t ~ z ~ X ~,.y~ ir e . _ . . . _ . . . . -~a " . !"J: ~ ! '`c: b _ =.f - ' "''rf ~ ~~°3 ~ z . Y ~ ~ ~ 'iLC~° _ , ~ _ i . ~ t -"..•,<„r~-.:n"?5^ ~'4~ ~ a , ~.ac - - ~ 'a't^~.~'~m .~-`~T'3:Y~...~-.-a - a`=~SPx