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HomeMy WebLinkAbout1309 i o. • a a- ti a a • ~ ~1 ~ t 42.409 ~ TO THE CLERK OF THE CIRCUIT COURT, - ST. LUC I E COU~Y~ ~,O~A; . ' This is'!ny declaration of Domicile and Citizenship in the Stag of Florida that I am filing thin day in accordance, and in conformity witb Section 222.1T. Florida Statutes. r..:,. I was former a kgal resident of ~ ~!Z ~7~ ~ - _ / ~ and I 4 resided at R~o~a~ /~t R~- IG r' l~• 1~'' _ However. I bavelehanged my domic~7e b (Sti.at and Nv~ber) _ and am and have been a bona Sde resident of the State of Florida since F~''~1 C' ~ ~7 ~ . 19_L_.. and I reside at oz o~cJo2 ~ / . Gc7Je~.i-fC ~K ~io,J J~ A~ l8t*•at aad Nambtl j i 6+7e C N ~ ST . l_ UG I E County. Florida, 1Ctty1 and this s4tement is to be taken as my declaration of citizenship. actual Segal residence and dominle in the S4te e[ Florida. IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES, CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECKS THEIR NAMES2 f i 1919 OCt t 2 a~ il~ 50 FILEO AFiO FtCtiRDF D ST.IUCIf COUItTY.Ft A. - ROGER POITRAS CLERK CIFCUI~ CU4,I~ 402409 I FURTHER CERTIFY that I wi71 register at my Ioca1 address when the segistratian books reopen. and comply with all other requirements of a legal resident of this Stag. I I FURTHER CERTIFY that I have no intention to return to my former domicile. and I intend to remain in T. U G I E .County. t (('iRyl i FlOrlda. permanendj. 9! • -~G-.. .w.,., as oa yy Sworn to and snbxtl~ed before me this ~ ~ day of ~ : ~ K C, I- A . 3.3y~U • ~cTObc r - ~ . A.D.19_ q - ~1 C ~ tN~ /"1 D ST ~ , ROGER PO I TRAS. CLERK OF CIRCUIT COURT ST. LUGIE COUNTY, FtORiOA - - i BY: • EPUTY LERK M ...r-- P.~~~3~.8 P~~~~04_