HomeMy WebLinkAbout0787 tion of Domicile nd Citiz nshi ~
Declara a e _ p . ,
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TO THE CLERK OF THE CIItG'IJIT OOUAT.
ST. LUC 1 E aptly, glpRmA; ~ _ ~
• This b ~ derLratbn d Damia0e and ie the State d I~7orida that I am SiieE tiffs deF i aoeoe+daaos. aeds
• oontarmit7 wit~$eetioa x.17. Florida 8tatnrte1a.
1 was i sm a kEai resident d /T
d N ~ S ~a. ~.L ~ ~ _ ~e h ~ and I
/ ~cw~ aaw -
- resided at ~,A / ~ e X ~ ~l
~ ~ _ Hewwrer. I have ~d aq7 da®eSs to _
18nMt atd N.r.r! •
and am and have bees a bona iide reeident d the State d Florida since v d 4 d
- g~ S ~~9•t/i sN L ~s Go ~ F d ~/a~.t.
19_. and I:eside at / '1 ~ O R I;?~d
~Or-~'.Sf. ~ u~ ~ z ~ ST. -LUG 1 ~e¦.~ cemlt,~I~laeida,
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and this stateme~ is to be tabn as sop dedaratioo d . aedual leant residsoee and doaie8s i, the State d Florida.
" IF FOR THE PURPOSE OF ENROLLING IF FOR HOMESTEAD PURPOSES
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES: i
' 19Sfl SEP 10 PK I2~ 16
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FILf0 ~!i[gFpElGOft0E0
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POIIRAS A.
ttEAK t~RCUtT COURyT~ ~
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I FtJRTI~A CERTII!'Y that I w~ rem at aq local address when the ~rtration boob reopen, and eompy wits aH
other regniremeats d a ieaal resident d this State, ,
I F[JRTAER CERTII~'li that I have no intention to return to mP farmer domio'le. and I istead to remain in
_ _ U C 1 E _ Cao~tj.
1Qt71~ - -
Fbrida.~ permanentl; .
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~F CAU~t`~ •t
Sworn to and subeQibed beiia+e me this dq d
.
•
.ROGER POITRAS. CLERK OF CIRCUIT COURT , -
ST. LUG1E COUNTY, fLOR1OA
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- - BY: e~ - . .mss
EPUTY LERK
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AGO Fom: 71.22
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