HomeMy WebLinkAbout0339Declaration of Domicile and Citizenship ~ ~
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TO THE CLERK OF THE CIIiCUIT COURT.
ST. LUG 1 E COUNTY. FLORIDA:
This b mT declaration d DomicIk and Citisenship in tbs State d Florida that I am fi4ng this daT in accordance. and io
conformity with Section 222.17. Florida Statutes.
I was f~ a legal resident d v R ~/ R N N /~ H ~~ and I
IGc71 18tate)
resided at y !5 ~ nl ~-' (,. E C.J cU G D l ~ ~ - - However. I Law changed ap domieds to
l8traat and NasDar)
and am and have been a bona fide resident d the State d Fbrida since ~ ~~- ds,T d
~D ~! t m h ~R .19~U and I reside at ~ 1 ~c~1 (~c~ F} 7-:: G~ ~ C' ~
(8e:.at sad Noasbr)
PT. .S r~ u c~ t ~ ST. LUG I E ~.~~,
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and this statement is to be taken as m,T declaration d eitisenship. actual legal residence and domid'k in the State d Flaeida.
" IF FOR THE PURPOSE OF ENROLLING
CHILDREN IN SCHOOLS PLEASE STATE
THEIR NAMES:
~~~~1Q ~n l~ r -/
~1~ ~l !1 r~ ~~1 ~ ! L
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IF FOR HOMESTEAD PURPOSESi
PLEASE CHECK:
1980 OEC -2 PN 2 37
i~lEO RNC FECOMOELLD
'ROGER POITRASA
ClER11 CIRCUIT CO TQ
509024
I F(JR1~ CERTII~'Y that I wID register at m7 local address irhen the registration booms reopen. and eomplT wilt aD
otter rcgnirements d a legal resided d this State.
I FURTHER CERTII~R that I have no intention to return tom former domia7e. and I intend to remain in
t _ __- U C I E _ Conat~
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I~7arida. permanents; .
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Swoon to and snbeen'bed beta~rs me this daT d ~J~ - ~'~ - %~c 1- c- . ~ - - ~=--~JC ~ .
ROGER POITI2AS. CLERK OF CIRCUIT COt~tT
ST. LU~,.,~ COUNTY, FLOR t OA ~ , ~ .
BY:
PUTY LtERK
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BO~KJ~~ PAGE ~ . + ~~--~
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