HomeMy WebLinkAbout0700 Decfaration.of Domicile and Citizenship-
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TO T~ CLERR OF T~ CIIiCUIT OOURT. .
ST . L UC i E - QpUNTY~ Fi.ORIDA:
• -
- This L m~ deeLsatioa d Domide gad G~tisanship is tbe.8tats d Florida -that I am fling thi: ds~ is soooedaaoe. gad is
- - contarmlt~ wltb Section 2?~.1T. ic7orida Statut~ls.
I was former a legal resident d SDfITHTt'~.~TI ~ - ~ ~yIE'•1 YJl'K and I
l4`k7) - 1&ab)
resided at 2 6 V I Lt .nGE ! !A Y ~ Hvwe~er. I bs.e ehangad aa~ doa~ia'le to
lsa..c sa I~loe.r) - -
and am and haw been a bang Sde:+ssidsat d tbs State d ~7orida siaoe 18'?'H dad of
nr.
-s..R - 19$~...aadlrasideat 5703 U~TIV''R~:ITY LAA!E
18er+iR aaa I~bsN
,ror.T PIL•P.CE ST. LUGiE CouatT.F7a~;da.
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gad this statement is to his taken as ao~ deela:atioa, d dfiseaship. adnal legal resideaoe and domiole in the Scats d Flaetd.
1 F FOR THE PItRPOSE ''OF ENROLLING 1 F FOR HOMESTE/lD PURPOSES,
CHILDREN IN SCHOOL, PLEASE STATE PLEASE CHECKS rte,-"~ t
THEIR NANESS j 1
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FIlrO RN[ ~::CCt~+?t 0
ST. LUCIE COJN ~ Y. f t A.
R06ER POITRAS
CIfRK Cl.TiClfl' CCU '
- i ~~CTi~iD FIf''n ~
so~sss
-
I FUItTl~ (~ATII+'lt that I wfl register at ~ local address whoa the regwtration boob reopen. gad aomgb with sD
~ other requtQ+sments d a iegal reodeat d this States.
i
l I F[JAT$EB CEItTTP'Y that I bane no intention to retm~a to former domie~e. and I intend to remain is
. Co®t7.
IC87) U C I E
F7or'ida. permsaensl; • -
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b ~Oli "lT~ % ~ s
Q ~ ~ Cl iE1R - S LJ. PIAT
y' ~ - 5703 U;~IfVEP,SITY L11'~E, ~~nP.T ?IEP.CE~ FLA. ~ 4
- Sworn to and sebeQ~ed befaes me this_.,.,~_ dp d .
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33450 `
r Clr_tn},or ,A.D.
ROGER P~OITRAS. CLERK OF CIRCUIT COC~tT
ST. LUG 1 E COUNTY, fLOR 1 OA ~ -
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EPUTY LERK ~ ~ -
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