HomeMy WebLinkAbout0142 . ,f`~ _ -
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Declaration of Domic~le and C~tizenship
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TO THE Cs.ERR OF THE CIItC[J1T OOUAT. .
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ST. LUC 1 E ~pt1~rY. ~I,p~iDA: • . ~
ZLb is a~ dael~ratbs o[ Domidl~ and (~ti~nsh~ in the $tat~ ot F7orida tlist I am Btios this da,~ in aoooedana. and im r
oo~tormicy ..itb seecion r~z.lZ. Plodaa stat~t+~s. ~
~ ~A~ ~'1S~ t'~ ol~ _ CL~~ aad I
I wu fornk a 1ega1 resideat o~
resided d l" ~l`~~1~.° -rt~ ~t~ ~ ~ ~ i. - How~ver. I 6aw,e~naed aq~ dosoidle t° ~
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and aen and Lave bsea a bona 6ds »sident ci fbs 8tste d Florida sinoe ~ da~ ot i
' 19~ aod i rssids st ~ I 5• W. C t~i r~ S S~ .
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aad this statement is to be tatien as m~ declar~tion o~ eitiunshi~. actual ksal residenoe and domidb in tbs State d Fforids.
IF fOR THE PURPOSE OF ENROLLINC IF FOR HONESTEAO PURPOSES~
CHIL~REN IN SCHOOL~ PLEASE STATE PIEASE CHECK: ~
THEIR NANES:
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S ROGER
POITRASa
CLERt( CIRCUIT COUij~j ~
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I FvRTHF~i CERTIFY that I w~71 tegister at m~ local address wbea tLe registrati~ books reopen. and oompl~ wiW all
~ oWer nquirements d a kgal reaident d thii Stat~.
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i I 1'If'Y that I have no intention to retnrn to m former domie~e. and I inte~ Lo remain in
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Fbr~da. permanena; . '
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Sworn to aad snbxribed bei~e me this v da~ of l O t- _ Ll~l L i~. ~/Q ~
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ROGER P01 TRAS. CLERK OF C I RCUI T GOt~tT
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ST. LUGIE COUNTY, FtOR10A - .
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