HomeMy WebLinkAbout0399 D~ciara~ion of Dor~icil~ and Citii~~n5~ii~ _
4'6995
TO THE CLERK OF THE CIRCUIT COURT. ;
ST. L UC I E Cp~TY~ ~,p~A;
This is my declaration of DomicDe and CItizenship in the State a'f Florida that I am IDing this day in a~.^ordanoe, and in
ooaformity with Section 222.17. F7orlda Statutes.
I was formed= a kgal resided of ~/J~
~ ~"•P- A t'r ''"~~~1 ~~A / ~ I
lC~l ,/t8tase?
resided st ~}1~~s~~ t,! -However, I have changed nqy domia7e to
(St:eat aad NomD~r)
and am and have been a bona fide resident oaf the State of Fbrida since T T - - ~ ~y ~
,19 n
v
- and I reside at ~ ^ 0 ,
n (Ste~s~taedNomb~M
~,,,1 ~G~E S7. LUG I E County.l"7orida.
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and this sUtement is to be taken as my declaration of citizenship. actual kgal residence and domia7e in the State of Florida.
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If fOR THE PURPOSE OF ENROLLING If FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES:
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~~E" A - 1980 ~'E6 25 ~ 3.32
FIiEe ~Ne I~Lco~cEo
ST.LUCIE COUNTY. FtA.
RQGER 1'OITRAS
CLERK CIRCUIT CO R~
- ~ RCC~t9~'fP~F'CL' -
4'7995
I FURTHER CERTII~'Y that I w>71 register d my local address when the registration books reopen, and ~mPb with aU
other ngniremeab of a kgal resident at this State.
I FURTHER CERTIFY that I have no intention to ntnrn to my former domicile. and I intend to remain in
U C E Count
7•
(Cthl . - -
Florida. permanentl~•.
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. cAea~.u 33
Sworn to and subsrt~ed before me this ~ sI dad of _ _ €
,~.ls..$o__ ~ r
ROGER POtTRAS, CLERK OF GIRCUI T COtdFtT
ST. L UC f E COUNTY, f tOR A
BY: ~
_ _ EPUTY LERK ~~c~~+ ~~p -
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