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HomeMy WebLinkAbout0141 • . . "1 / Declaration of Dom~c!!e and C!tlzensh~p X63589 TO THE CLERK OF THE CIRCUIT COURT. ST. LUC I E COUNTY. FLORIDA: This is my deelantion of Domicile and Citizenship in the State of Florida that I am filing this day in aooordance. and in conformity with SeMion 222.1T. Florida Statutes. I was formerly a legal resident of _ ~ ~ C'oC oi(' i~ O and I IGl'tyl IState) resided at 2 d - ~ ~ - . However. I have changed my domicde to 13treet sad Number) ~ ~ f and am and have been a bona Gde resident of the State of Florida since ~ 2~ day of ~c /i 0 i3 j= ~ .19~. and I reside at ~ f ~ ~ ~ ~~BG, /U ~o o ~ (8treec sad Number) ~~t= X15 ~ x % ST = L LAG 1 E Cu~~ty. Flo~dai (City) and this statement is to be taken ss my decLrstion of ©tizenshipi Ti2tual legal residence and domicile in the State of Florida. IF FOR THE PURPOSE Of ENROLLING' IF FOR HOMESTEAD PURPOSES, CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK: THEIR NAMES: ./~~~1 ! :,;/1~~ /'~v-l+/fir X09 ~Ct 24 FF' i2= G3 FIL':~0 Aft; ~~C: 1-i: U ST.lUC1E CGUNi Y.fli:. ROGER POITRAS X63589 I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and comply with all other requirements of a legal resident of this State. I FURTHER CERTIFY that I have no intention to returo tom [armer domicile, and I intend Lo remsin in U C 1 E County, (City) . Florida. permanenti;. _ :J'`•'~5~~• l ~ G L'~ mot/ C•r - ~r: _ _ (Name) ' ~JR~ x.11 ~~~~la~sr f'1 t` l~, SWOTD toiji~deulhi iiibefore me this day of _'~r 5 ~ lV t~ ~ l~ C F L ~ . A.D.19_ 9 ROGER P01 TRAS, CLERK OF C iRCUI T COURT ST. LUCIE COUNTY, FLORtOA BY: ~ _ EPUTY LERK ii(1~Y319 PdGE 141. ~ ~ ~ -