HomeMy WebLinkAbout0510 Declaration of Domicile and Citizenship ~ f' `
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TO T11E CLERK 0~ TI~E CiRCU1T COURT, ~ ~
ST. LUC 1 E apuNTY, FI.ORiDA: _ ;
Tbb ls m~r deelaration ot Domkile ~nd Citl:on~hlp ia the Stats of Florida that I un tiltns thV da~r in uxordanoe. and ~n
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conformily rvith Section 222.17. Fbrida Statutes. ~
I wu tor~m.
e~rl • kg~i resideAt oi . ~T~C~'' -S_ - _ R~~~ I
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/17 5 - Howevar. I have ehaaged nU? doadcile to
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/ S 7- - - dar ot
and a~a aad have been a boaa Gde resident oithe State oi F1orlda aiaee
FC~~P~//12 Y .19 ~ Z. and I reside at ~Od Z h~i ~1.~~dS ~`E
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- IBteeK aed Nm~bKl
FT Di ~t71Cf"~ ST. LUG I E County. Fbrida.
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aad this statemeat Is to be taken a my dee4ntioa of eitiseaship. actual kgal residcnee aad domieile in the State ot F'brida.
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If F'OR THE PURPOSE OP ENROLLING IP POR HOMESTEAD PURPOSES~
' CNIIDREN IN SCHOOI~ PLEASE ST/1T6 ~ PLEASE CHECK:~ ~
THEIR NAMESS . ~
/fC fI~LO' L~'f- /'~iiY . ~ RECORDED'- ~
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, r~UR~Y FLA.
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~19 FEB ~ 3 AM IQ : 34 ~
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I FURTHER CERTIFY that I~1 register at my local addres+ when the registntioa booka reopen. and eomply ~rith all
' other requiremeats of a legal resideat of th~s State. i
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I FURTHER CERTIFY that I have no intention to return to m tormer domicile. and I 10LCAa to rema~n in ~
, . u c ~ E _ County,
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B Florida. permanenti;. -
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~ Sworn to and subseribed betore me this ~ day of ~T in/t~CL' ~L~ 3 34 v'S ;
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~ ROGER POITRAS. CLERK OF CIRCUIT GOURT ~
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~ ST. Ll1C i E COUNTY, F ~OR t UA ~ ~
~ BY: '
~ EPUTY LERK
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604K ~ ~
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~ ~ • AGO Fo~m 91-22
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