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D~clara~ion of Dor~icil~ and ~i~i~~nshi~
4'75832
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG ! E COUNTY, FLORIDA:
This is aN' declaration oaf Domip7e and Citisenship in the State of Florida that I am Sling this da,T in accordaaoe. and is
coaformit~ with Section 222.1?. Florida Statutes.
I was former a legal resident ~ - ~ and I
ii~4) f3tate)
resided at /~s/.~ C ~/FF o~E'll AU _ - However. I have changed tqT domide to
f!)trMt aad Namtssy _
and am and have been a bona Sde resident of the State of Floridasince daT of
FF,6~C'u AR 5~ , I9_~. and beside at /J O (o Su t Tfl ,t! ~ ~P I (1 ~
18tr~ aodNomMd
~a R r ~T. tc c i ST. LUG I E
and this statement is to be taken as mT declaration of citizenship. actual legal residence aad domia7e is the State of Florida.
IF FOR THE PURPOSE OF ENROLLING 1F FOR HONESTEAD PURPOSES
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:-
THEIR NAMES:
A7~CHAEL ~3a3~j'N SE~tJk'S
1980 FE3 22 Illy ii= 08
FIlEO AiiO FECUit(k U
S? LUCIE COi>?iTY.FIA.
ROGER POITRAS
CLERK CIRCUIT COURT D
4'76832
I F'tJRTHER CER1'II~'Y that I wiII register d aq local address whey the rcgistratioa books reopen, and oompl,T with aD
other requirements ai a legal residert of this State.
I FURTHER CERTII~'Y that I have no inteatioa to rtturn tom former domicile. ssd I intead to remain is
~'_"'~...7s~7.~-.~?.~.~ f~7) ! ~ T . U C 1 E . Conntj,
Fbrida. permanemi;.
aif~ft; j~~.~
!i:
ii..
.r u~; - ~ ~ { . /fI AiE',t't / % A ~ E. til k~s
~~~.'?~s:ss!,s'3'.~~~ ~ GQ~o ~5 c.L L TA Al D ~C' ~ ll~ .
fAdd~.+a
sworn to and subscribed before me this d~ ~ _ _ _ ~o ~ ~ S ,C C /E,~ F N . 3~ SAS-?
- . A.D.12 ~
Q
f
RACER POI TRAS, CLERK QF' C IRCUI T COtdFtT
ST. LUG I E COUNTY, f tOR 1
BY:
_ EPUTY LERK
~~3~ Pa~F iT2