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4b2503
TO THE CLERK OF THE CIItCUI'f COURT.
ST . LUG 1 E_ COUNTY. FLORIDA: .
This is'>a?T declaration of Domiu'le and Citiumhip in the SLte of Florida that I am Sling this daT is accordance. and is
eonformit~ with Section 222.17. Florida Statutes. .
I was former a kgal resident of ~ n~~~- - -~J
1~ and I
II~t71
resided at ~ ~ ~ ~ c ~ - However. I have changed mT domiesle to
(Sweet and NnmDetl
and am and have been a bona Sde resident of the State of Florida since ~ dal ~
- 19~ and I reside at ~ b ~ e-~~ - }
(8treat and Nnmber)
p~~,~_ V~~~ _ ST. LUG I E Count~.F7orida.
Itatt7l
and this s4tement is to be taken as mT declaration of citizenship. actual kgal residence and domicSe in the State of Florida. l
li FOR THE PURPOSE OF ENROLLING Ii FOR HONESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK: ~ }
TNEIR NAMES: `U
A - ~~e ~ Cti h
?r9 Q~T IS A~ t?R
' r ILEi? ~nE ~c l.i;r:ilt il
SLLUClE COJNTY.Ft .
ROGER POiTRAS
ClfF.K ClRCUli %Dt!°T
k
i
462503
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I FURTHER CERTIFY that I w~ register at mT local address when the registration boobs reopen, and complT with all
other requirements of a legal resident of this State.
I FURTHER CERTIFY. that I have. no InteDtlOn to return to m~ former domin7e. and 1 intend t0 remain in
~ T. U C 1 E _ CountT.
~ r
Florida. permaaeDtl;.
•
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- - ~~DUNTyC~ ?
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Sworn to and snbs~!'fore me this daY of
~ ~
- dctobeF .A.D.19;~9 ~yil*~iNia SMi~'l~
RQGER P01 TRAS, CLERK Of
C i RCU I T COURT
ST. L UG I E COUNTY, f LOR 1 oA
-
BY:
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