HomeMy WebLinkAbout2818 _ _ . ' _ . F
M~~ct~~•~tiQn of Domicile and Lifii~~ns~~ip - ~ ~
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, 45202'7
TO THE CLERK OF THE CIRCUI'f COURT. ~
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ST. LUC 1 E ~pUt~rY. Fi,ORIDA: .
This b m~ deelaration of Domicile and Citiuaship in the State of Florida that I am filing this da~ in aa~ordanee. and ia ~
conformit~ witb Seetion 222.17. Florida Statutes. ~
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I was iormerl a legal resideat of ~ =
((~t~) IStakl
resided at ~ DL E 2 S) Ho~vever. I have changcd m~ domic7e to
IStred aod Numb~rl . -7
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and sm and bave beeu a bona Sde resident of tbe State of Florida sinee 1 4` h ds~ d
..~V L~/ _ 19~~L and I reside at ~ a 7-3 s E~ F~~ l' _
(3Ue~t Numbar)
po /1 T ~7' ~ V c,~ ST . L UG I E Count~. Florids,
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and this atatement is to be laken as m~ declaration o! cituenship. actud legal residence and domic7e in the State ot Florids.
IF FOR TH~ PURPOSE OF' ENROILING IF FOR HOMESTEAD PURPOSES~
CHiLDREN IN SCHOO~~ PIEASE STATE P~EASE CHECK: ~
THEIR NAMESL
~D t-~ rv G- 1~~ S~~~
` ;°19 J!~'.. I 8 P~ 1= ! 0
~.cJ~,~DV ~ ~ESGEr2 _
~~<<o ~ke F_cu~~o
C ~ ~ - ~_~sL~ $T.lUC1ECQUNTY.ftA.
ROGEft POITRAS
~ ~ - - - CtERK ClRCUIF CG~~~±
r";^^.PO Yf.=:,; trQ
~ ~ - 45202'7
I FURTHER CERTIFY that I w~71 register st m~ local address when the regi+tration books reopen. snd oompl~ ~-ith aD
other requirements of a legal resident of thii SUte. "
~ I FUB1'HER CER1'IFY that I have no intention to return to my former
d~mi_7e. and I intend to remiin in
J
i. _L V~. 1 L _ COt1nL~.
i l~11 .
Florida. permanentl;. i
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~ ~ GIE~K ~ ~ .
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~ Sworn to and subscn'bed before me this ~ da~ oi P~1 s% 1/C~ ~L/'j) ~~~i/s~
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~ ROGER P01 TRAS. CLERK OF C 1 RGU I T COl~2T .
~ ST. LUGIE COUNTY, fLOR10A - . _
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• EPUTY LERK ~ •
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