HomeMy WebLinkAbout2623Declaration of Domicile and Citizenship ~ ~
' 51040
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUC 1 E COUNTY. FLORIDA:
This is mT decLration d DomiAs and CIti:emhip io the 84te d Florida that I am SIIng this daT is aooordaaoe. and is
ooatactnkT with Section 222.17. Florida $tatutea.
I was former a legal resident d ~/y~~'/t' l( ~A ~`i% 1/ ~/f f S - and I
• ,. 1cf41 natal.)
resided at .S-O / •I~.~ro ~ ~ P 0`- A.OT / y _ However. I have changed mT domidle to
(flta~st and N~eK)
and am and have been a bona fide resident d the State d Fbrids since ~`~ daT d
~/~ °~- .19,~. and I reside at ~~40 ~/' OG6l,1~V ~.P- ~ ~~ 3 3
/~ (8tr~t and Nombr)
~.e i l/FiP N F ST. LUG I E ~~ Via,
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and this stateme~ is to be taken as ap declaration d e3t3renship. actual legal residence and domicile is the State d T'7orida.
IF FOR THE PURPOSE OP ENROL'L11~fC IF iOR HOMESTEAD PURPOSES,
CHII.OREN IN SCHOOL, PLEASE STATE PLEASE CHECK:
THEIR NAMES:
1980 DEC 12 PN ~ 23
FILED RNG ~f CURDED
S1.LUCIE COUNIY.F``A.
ROGER POITRAS
CLERK CIRCUtt CDUR~
51n420
I FURTI~Et C~tTlFY that I will register at mT local address when the registration books reopen, and comply with all
other regnirements d a legal reaident d this State.
I FURTHER CERTIFY that I have oo intention to return to former domie7e. and I intend to remain in
U C 1 E . Cotmtj.
(Cigl
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• • .8rso~ittlipd~6.aibea before me this ~ day d
~ i r, u~ !mow- ,_
GG {AYY.1../
/~e /Yip y ~ .
)/ are f-i~e 1rY1
ROGER POI TRAS. CLERK OF CIRCUIT CO[~tT
I ST. LUGIE COUNTY, FtOR A
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EPUTY LERK
X344 0,x2622
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