HomeMy WebLinkAbout0936 `~`~~~°5 D~claration of Domicile and Citizenshi
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TO THE CLERK OF THE CIRCUIT COURT. ~
ST . L UC I E COUN'1'Y, FLOxIDA: ,
This is m~ decluation of Domic~e and Gtilizenship in the Statt oi Florida that I am filing this da~ in accordance. and in
conformily with Section 222.17. Florida Statules.
] was lormerlv a legal reside4t of and I
_ 1 ' 7) lSt.ta1
resided at . However. I have changed m~ domic~7e to
lStiect Rnd ber
and am and have beea a bona fide resident of the State of F7orids sinae _ day oi
.19 ~ . and I reside at d ~ L / ~`'t /q S ~ ~ L L/ d ,
~-v 2`r' S 7~ L v c, ~ ST _ ~s~•~a N~„~~
L l1G 1 E Count~, Fiorida,
1~7) .
and this stat,ement is ta be taken as my dedaration of c~tizeaship. arfual Jegal resideace and domic7e in the StaLe oi Florids. '
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FOR THE PURPOSE OF ENROLLIN6 IF FOR HONESTEAD PURPOSES~
CHILDREN IN SCF{OOL~ PLEASE STATE P~EASE GHECKt ~
THEIR NAMES:
4Q'7205
I919 JJ~~ -8 Pt~ I= 33
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SLLUCtf C~ 7Y. A.
ROGER POITRA~
CLERK CIRCUlT CO T
F.ECOP.O YFRIFtEL__
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1 FURTHEA CERTIFY thst I w~71 register at my local addresa when the registration books reopen, and compi~ with a!1 '
other requirements o! a Iegai resideat of *_his State.
' I FURTHER CERTII~'Y that I have no intention to return to my former domic~7e. ar~d I intead to remain in
T~ U G I E . Count~.
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Florida. permanenti,: ~
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S+vorn to aed subsm'bed before me this day of O J~ 1 O i4 3 3 y s-a
J v ~1/ L= . A.D.19
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- ROGER POi TRAS, GLERK OF C tRCUt T COt~2T .
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ST. LUGIE COUNTY, fLOR1OA • • -
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