HomeMy WebLinkAbout0332 ' Domicil •nd Citizenshi
Declaration of e a p
495105
TO THE CLERK OF THE CIRCUIT COURT.
ST . LUG 1 E COU~Y, ~,O~A;
_ . _ .
This is my declaration of Domicile and Citizenship in the State of Florida that I am 51iaa thin day in accordance. and in
conformity with Section 222.17. Florida Statutes.
I was former a kgal resident of i~ r ~ A~~ - ~ y and I
~ 1 ) 1 )
resided at 3 f•1•te~ h\'D G E C ~ R _ However. I have changed my domics7e to
18trat aed Nnmbpl
and am and Mve been a bona fide resident of the S4te of Florida since ~ ~ ~7 ~
19~ and I reside at ~ l 7 S ~ ~ v w e c- S'H-
18tnatand Nambar)
Q~ ~ c ~ ~ _ ST. LUG I E County, Fbrida.
local
and this statement is to be taken as my declaration of e~tizeaship. actual legal residence and domidle in the State of Flaa~ida.
I F FOR THE PURPOSE OF- ENROLL. LNG I F FOR HOMESTEAD PURPOSES,
CHILDREN IN SCHOOt., PLEASE STATE PLEASE CHECK:
THEIR NDA MQE~,S~:
• i~lTQ~h7~ f ? 1 ~ -
Q- r 190 AUG -5 PN 12: 09
_
` Qn ~AJU~Y~ C FIIEO QQ fECOR0E0
SL LtJC1~COUN TY. iL A.
ROGER POITRAS
~IRCIgT COURT
' RECORD ~'FRlPIER._`~-
_ ~ 495105
.
-
i
! I FURTHER CERTIFY that I wi11 register at my local address when the registration books reopen. and comply with all
t other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no inteotioa to return to my former
d~~. and I intend to remain in
~ J T. t_ U G I E ,County,
_ !City)
S
g Florida. permanenti; .
1
~ C~~N
r
(A1ama)
~ S~.~~Q'
Sworn to and subscribed before me this ~ dsy of
' ~
t O r
A.D.19~ !
ROGER POITRAS. CLERK OF CIRCUIT COC~2T
~ ST. LUGIE COUNTY, fLOR1DA ~
• ~ - ? w ~
BY : c-~
f
E PUTY LERK ~ _
4R
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