HomeMy WebLinkAbout0933 Declaration of Domicile and Citizenship ~
4129
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG 1 E (;pU~*y, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in acoordanee, and in
eonformit~ with Section 222.17. Florida Statutes.
•I was formerly a legal resident of ~L~C~ nail I
resided at 7 ~ f ~ d ~ i~ . However. I have changed my domicile to
(8traat and N )
and am and have been a bona fide resident of the State of Florida since. ~ ~ ~7 day at
19__.____. and I raaide at ~1,~,~L,~!(-~OOG( /~~/Ll~-L.~.~
(8traat and NnmDar)
~f ST. LUG I E County. Fla;da, ~ .
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and this statement is to be taken as my declaration of atisenship. actual legal residence and domicile in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN tN SCHOOI, PLEASE STATE PLEASE CHECK:
THEIR MAMES:
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~~'9 QCT 29 ~N 3- t 4
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ST.LUCIE CG4tiTY.FLA.
ROGER POITRAS
CIEFiS CIR:"•U1T COUR
' 4129
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 return tom former domiu7e. and I intend to remain in
U C I E , Count.
t~~~~'' ~-latr)
Fbrida. permanenti; . .
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sworn ~ ~ sabscn'bed before me this a / . nay of ~L~~ ~f
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ROGER P01 TRASH CLERK OF CIRCUIT COURT
ST. LUGIE COUNTY, FtOR1oa
EPUTY LERK
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