HomeMy WebLinkAbout1367 Deciarat~a~r~ of ~om~c~ie and Cit~z~nship
4'73888
TO THE CLERK OF THE CIRCUIT COURT. ~
ST. LUt:~ 1 E COUNTY. FLORIDA:
This is rep deeiaratioa of DomieOe and Citizenship in the State oI Fiorids that I am BEng this dq in nroordaaae. sod in .
oonfannit~ with Section 22Q.17. Florida Statutes,
I was fonaer :legal resident at _ ~G ~ - ~ ~L/.1! and I
(t~t71 18taW
resided at 7 ~ Vf
/~'rl
r~ IPA S / • ~ Aowever. I haw chapged o~ doamie7e to
. ISvw. sad NON - C _ -
and am and have been a bons fde resident of the State of Florida since A^^1 • / S 7 ! dsy of ~
' 19- - snd I reside at ~4 SALER,?O /4~~ - - ~ _
(BtrNt sad NAmb~
/~~c''!' i~E/fi~ _ `,i41~~ w/oaQ f~it~ ~ ~ ST. ~ LUG I E Connt~.2~7orida.
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and this statement is to be taken as ~ dsclaration of eitisenship, actwl legal residence and domicile is the Stata of Florida.
IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES,
CHIt.OREN IN SCHOOL, PLEASE STATE PEASE CHECK: _
THEIR NAMES:
r -
_
FILED ANL~ REC(kc0E0
ST.LUCIE COIMTY.FLA. _
- ROGER POITRAS -
CLEitK CIRCUIT COURT _
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I FURTHER CERT'IF'Y that I ~ register at mT local address whea the registration books reopen, and oomprj with all
other requirements ai s legal raside~ at this State.
I FIJRTI~R CERTIFY that I have no intention to return to former domiak. and I intend to remain is
UCIE -
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Fbrida. permanentl; . ~ - ~ ~
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" = .fi..~ QI,Z~P ~WO~~'~G1lgS
Swann to, ' d subacnbed before me this ~ ~ dq of ro ~'T /%e~'r - k~~ ~d0 f''~ _
_ AS K OF CIRCUIT C0~2T - ~
S UG N
T. L IE COU TY, FLd210A
EPUTY LERK '
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ATO Forri ?l