HomeMy WebLinkAbout2356 i ~
.
(r f r
Declaration of Domicile and Citizenship ft-'
431884
TO THE CLERK OF TAE CIRCUIT OOURT.
ST. LUC I E oovlv'1'~t. FLi~itIDw: .
Tbb b mr dseLration d Domklb and Citbenahip is the State d Florida that I am ~ this dp is aeoordanos. and b
eonfor~asitT wtt6 Section 228.17. Fbrida Statutes.
I was i rme a legal rsaideat of d ~A~ Q c ~ _ ~~i . c~ and I
n lpt,~l llltaW
resided at ~ ~ ~ o,~. S* - - However. I baw ebanged my domieRs to
. ( aaa Noel
. and am and Gave been a bona Sde resident of the State d Florida since ~ c c~ dy of
a~ k ~ ~ 5
maw c ~ .19 n _ and I raids at V o . 1C T
lea..c Hoed
~o r S~ 1- , ~ _ ST. LUG 1 E Con~.>E7aida.
tc~l
and tbb statement b to be taken as m,T declaration of eitiseaship. aetnal bgal residence and domicije is the State of 1:7oeida.
IF FOR THE PURP08E OF ENROLLING IF POR HOMESTEAD PURP08E8a
CHILDREN IN BCNOOLa PLEASE STATE PLEASE CHECK2
~ THEIR NANE82
1 \ , ~ ~ ~ - ~ APR _3 P!t ~ i
ST uu P~s
11G~ T T
C ~ - ~ vJc~ t' a OLEIgt CNEGW
RfClM10 VERIFIED
al+j' C Y1 t' t!'
_ ~ L'~~
i
t
s
i
i
I FURTHER CERTIFY that I w~71 register at mT local address when the regbtration boob reopen. and eompl,T with aD
otber regnireme~a o: a bgal resided of tbb State.
I FURTHER CERTIFY that I have no inteatioa to return to former do~7e. and I intend to remab is
~ ~ _ _ U C 1 E Countj.
1
_ -
`~NT`,,~,
j
~ fir'
~ _
't, j~~ 1,
i~~
sworn to and sab.eribsd before me thb 3 aaT of 1
A.D. i~~
ROGER POITRAS. CLERK OF CIRCUIT COt~FtT
ST. LUG I E COUNTY, fLOR 10J1 -
8Y s ~uLtcQiL . • .
EPUTY LERK
t~ ~Q
_ ~ BOO1C~~ P1GE~reJv~
AGO Form 7]-~