HomeMy WebLinkAbout2718 46'71,25
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG I E CONY, ~,O~A;
This is my declaration of Iomicile and Citizenship in the S4te of Florida that I am Sling this day in accordance. and in
conformity with Section 222.17. Florida Statutes.
I was formerly a legal resident of ~ and I + ~
ICKy1 1 ) i
resided at ~ / - However. I have changed tqy domicile t0 r
(St»at and Numbat)
and am and have been a bona fide resident of the State of Fbrida since ~ ~ day of
y~
19-J? , and I reside at ~ O ~ / ~ 5 7 ,
(Start and Nambar)
~y ~ ~.u , ~ ST . LUG I E County ~
Icuy)
and this statement is to be taken as my declaration of citizenship. actual legal residence and domict7e in the State of Florida.
t1
IF FOR THE PURPOSE OF ENROLLING If FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE ~ PLEASE CHECK:
THEIR NAMES:
F!l!C AHi ic~~r's: t~
SLIUCIf CCUYTY.FI.:..
ROGER POITRAS
CLERK Ct4~JET C~U?
-•i~r;-n
46'7125
i
I FURTHER CERTIFY that I wdl register at my local address when the registration boots reopen, and comply with all
other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return Lo my former domicile. and I intend to remain in
T. U C 1 E ,County,
~ ICttr)
~ Fbrida. permanenti; .
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Sworn to and subacn"bed before me this ~ ~ day of /~f.~ ~C-oA~~7 J -
r _T -
A.D.19_
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ROGER P01 TRAS. CLERK OF C i RCU I T COURT
ST. LUCIE COUNTY, FLORIDA
EPUTY I.ERK ~ .
E ~
! 800K P1~~~~~ • ~ r .