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Declaration of Domicile and Citizenship . ~ •
• 4'~2~15
TO THE CLERK OF THE CIRCUIT COURT.
ST. ~UCIE
COUNTY. FLORIDA:
This is my declaration of Domia7e and Citizenship fn the State a! Florida jhat I am filing thiv day is accordance. and in
conformity with Section 222.17. Florida Statutes. ~ / .
I was loaner a kgal resident of " ~ ` ~v and I
, ~ ((2t71 , lStaW
resided at ° n However. I have my domide to
l3trart and Nomb~el -
and am and have been a bona fide resident of the State of Florida since day of
y - .19~ind I resi at 1.G~G t-
and NaaaDar)
c u~ ~ S T. LUG 1 E County Florida,.
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and this statement is to be taken as my declaration of e~tizenship. actual legal nsidenee and domicile in the State of Flacida.
IF FOR T.NE PURPOSE OF ENROLLING If FOR HOMESTEAD PURPOSES
CHILDREN IN SCNOOLa PLEASE STATE PLEASE CHECK:
THEIR MANES:
- - ~ 1980 JAN -9 A13 II~ 25
- _ - FI E9 ANO EECUR:?EO
- S ROGER
POITRAS
. n c~K ctecmT COURT
J. ~ ~ RECORD VEFIfIL~_
4'72415
I FURTHER CERTIFY that I wRl register at my local address whea the registration booJcs reopen, and eomplT with all
other requirements of a legal resident of this State.
I FIJR'1TlER CERTIFY that I have no intention to return to my former domiu7e. and I intend to remain in
U C 1 E County
((Std) .
Florida. permanend; .
i'
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L~~,, ,
_ .y , _ _ C
' •.:.y:~'' •~gti:=
~'!.~C/~r_:;~~ (Name)
L
Swore to and subscn3ed before me this C ,day of ~ , ~J _ 1-- - - 3 3 ~j S Z-
Q
A.D.19 V~
ROGER POI TRAS. C RK OF C IRCUi T COCdZT
ST. LUCtE COUNTY, FLORIDA -
E P r L R K ~c 3 ~'iQye 1393