HomeMy WebLinkAbout2125 uec+a~~~i~i4 or uv;~~~~j~e anc~ Li~~zenst~ip
4'71)568
TD THE CLERK OF THE CCIIiiCUIT OOURT.
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Sty LIIC i E Cpj~y~ ~,p~A;
~ `;'!'his is nA1 deeLsatioa o[ Domic~e and (~t~eaship in the State of Florida that I am Ains this daT m aooardanoe. and is
conlozmitT with Section 2?Z.1T, Florida S4tntes.
I was fob a kgat resident of c « v.: ~ v~ ~ ' and I
- tCft7) . 19t~te1
~ flowerer, I Lave cbaaaed m~ domiale to
tStr.d and H -
and am and Lave beta a bow 5de resident of the State oaf Florida since ~t dad a[ i
c ~ .rte -19 ~ and I ride at „K., ; y `j .'7 .'S .
tt3tsMt acct Iirb.r)
e ~ ST. LUG I E Coontp. Florida.
tCU~I
and this statement is to be taken as mT declaration aI atizenship, actual legal residence and domiole in the State of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL,~PLEASE STATE PLEASE CHECK:
tHE1R NAMES:
s1. ~
i9T9 DEC 26 PM 2~ 18
FILEO ANC RECOItajO
SL LI?CIE t:01iN 1 r ~ A.
ROGER POITRAS
t:t.ERx CIRCUIT c T
RECO11QYf.Rif1EC____-- -
_ - 4'7(1568 - `
I FURTHER CERTff'Y that I w01 register at mT local address when the registration hooka reopen, and oomplT with all
other regoiremenb os a legal resided of this State.
I FURTHER CERTIFY that I have ao inttntion to return to mT former domic~t. and I intend to remain in '
T. U C t E _ Count~~
- t(St~?
Florida. permaaend;,
}`r'`'~ Q
_
_
Swami tb•''. . b~before me this ~ ~ dad of .
1
ROGER PO 1 TRAS. CLERK OF C 1 RGU i T LOUR T ~
ST. IE COUNTY, FLORIDA -
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BY: ~ ~ c a,:'~322 ~~2118
' 1CDIITY _1 rDr