HomeMy WebLinkAbout1304Declaration of Domicile and Citizenship ~
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5 '03
TO THE CLERK OF THE CIRCUIT OOURT.
ST. LUC I E OOUNTY. FLORIDA:
This is ~ deeiaration d DomkiM ae+d ~ in the State d Florida flat I am i9ias this dp is aoooedaoa. and is
oonfarmftT with Section 822.17. Florida 8tatntes.
y ~
I was i~ a legal resided d '~ S ~ and I
_ _ Y 1 lCb1 l
and am and have been a bona 5de resident dthe 8tats d77~ocida since
19~~ I reside at
ICM~
IF FOR HOMESTEAD PURPOSES,
PLEASE CHECK:
1980 OfC -8 PEI 12: 14
and this statement is to be taken as mT declaration d eitisenship. actual legal ersidenos and doaeiAe in tbs State d Florida.
iF FOR THE PURPOSE OF ENROLLING
CHILDREN IN SCHOOL, PLEASE STATE
THEIR NAMES2
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FILEe attc F~coROfo
stwcElE cp~j rr.Fl~-.
CLERK CIRCtNTTC AST
pFCr,!!n l'~RICI(.n_
509603
I FURTHER CEEtT)F3i the I wiII rem at mT Ioeal adders: when the registration booms reopen. and eomp~ wits aD
other rrgniresoents d a lesalresident dthis State.
I FURTHER CERTIFY that I have no intention to return to former domiee'le. and I intend to :retain io
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ROGER POITRAS. CLERK O F CIRCUIT COt~ZT
ST. IE COUNTY, fLOR10A
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Consttj. Florida.
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