HomeMy WebLinkAbout1371 Declaration of Domicile and Citizenship
4'7195
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG I E COUNTY. FLORIDA:
This ~ my declaration of Domicile and Citizenship in the State of Fbrida that I am f~7ing this day in accordance. and in
conformity with Section 2?Z.1?. Florida Statutes~~./
I was former a legal resident of ~QO/ ~/Q C - ~ ~ I
!City) tStatd
resided at 1 ~3 G~D ~ ~ n '~2 . However. I have clanged ~ domicIIe to
Strad and Naaabar) ~
and am and have been a bona fide resident of the State of Fbrida since ec ~ 7 d+7'' ~
1911_. and I reside at - ~S~ ~ .S ~eLIPrQ-~ J~W l~
(Surat acid NnmDar)
~r~- ~~~~C ~ _ ST. LUG 1 E qty,
cat,)
and this statement is to be taken as my decLration of citizenship. actual legal residence and domic7e is the S4te of Florida.
IF FOR THE PURPOSE OF ENROt.t.ING IF FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE gTATE Pt.EASE CHECK:
THEIR NAMES:
Lei-h~>1 U ~lc~ri e, ~~he r
_ 1980 J4N -9 9. 46
f1LED ~NL pfCORCE~
S
ROGER POITRASt
tRK CIRCUIT C0~ D
r.._- ~_L=-_
D ~ERIFI:T---
4'71995
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 domicile. and I intend to remain in
U C 1 E County.
~ ,((Sty!
E
Florida, permanenti; .
Li~~ 'r.,.
_ _
-
- ~ ~ 'i ` !Name)
-
~ Sworn to and subscn'bed before me this ~ day of
~ 1-~, _ . A.D.19~_
- -
ROGER PO I TRAS. CLERK OF C I RCU I T COC~2T
ST. LUGIE COUNTY, F~OR10A
~ EPUTY t.ERK
BINKJ~.• ~lGE~e)11ey