HomeMy WebLinkAbout0623 ~ .
Declaration of Domicile and Citiz~nship `
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4~8961
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TO TNE CLF.RK OF THB CIRCUIT COURT. ~ '
ST. LUC t E CpvNTy~ FI,pRIDA:
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This is mJ declaration of Domic~7e and Citizenship in the Stat,e oi Florida that I am filing this daJ in aceordance. and in
conformity with Section 222.17. Florida Statutes.
I v? as formerlv a legal resident of C o%/_~[„f1.ls ,~i ~d 1
. ICit~) (State)
resided at s~~7'D /~lAP~,~(~ C T . However. I have chinged m~ domic~e to
IStreet aad Number)
and am and have been a bona fde resident of ths State of Florida since _/N_4 3?~ day oi
-19~_. and I reside at ~,l11- ~•P~ ~~~,SC r.C~/dG+~
(Street and NumDer)
1
oz : I~.~.e~ c , ST . l lJG I E Count~, FJorida, -
lG~t~)
and this statement is to be taken as my declaration of citizeaship. actual legal residence and domidt in the State oi Florida.
IF FOR THE PURPOSE OF ENROIIlNG IF FOR HOMESTEAD PURPOSES~ ~
CHIIDREH IN SCHOO~~ P~EASE STATE PLEASE CHECK:
THEIR NAMES:
:979 J!~i= 22 F~ 2~ ~2
F«EO ~MO F~ cuhu~u
. . SLLUCI~ COUNTY.FLA.
ROGER POITRAS
C1ERK Clt'CU1T COUR
RzC^RD ~'F~IF!F~_~.
445961 ~
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~ I FURTHER CERTIFY that I will register at my local sddre~~ when the registration books reopen, and comply with aU ;
~ other requirements ot a 1ega1 resident of this State. `
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~ I FURTHER • CER1'IF'Y that I have no intention to return to my former domicilt, and I intend to remain in ?
T. U C 1 E .~~ty. ~
~ ICit~) _ ;
Florida, permanenu;.
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: - _ ' ( J-1 i4jPc,~ 1 -1-. L o~ ~ ~ )
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F _ `GC~f COUNt`(•H'~Q (Nam~)
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S and subscnbed before me this day of f~' i /~/Ei2C, i- /3 /?e~ •
~ A.D.19
; ~9 • ~
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~ GE PC~ITRAS. CLERK OF CIRGUIT GOl~2T
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` ST. LUG i E COUNTY, FtOR 10~1 ~ • ~
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~ BY: ~ _
. EPUTY LERK ' ~
' ~ 30L~!! 311 ?AGF , ~ - . ~
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