HomeMy WebLinkAbout0959Deciaration of Domicile and Citizenship
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T01'HE CLERR OF THE CIItCtJ1T OOU~iT.
ST. LUG 1 E ~pv~y. ~,p~~:
Thb is ap 3selaration ot Domic~s and Citisem~ip in tbe Stats ot Flo~id~ that I am IDins tbis da~ ia aoooidanoe. sad in
coniozmft~ wit6 Seetion 222.17, ~7o:ida Stat~es.
I was f~ a kgal reaideat ot ~/.T ~~7 `~ 5 fo w h d~ O _ snd I
1 lqt7) 18ew1
resided at ffY~ .r ~'f'~ ~Q vV vUd ~v : - Aowever. I bave ebanasd a~ domi~s to
(8te.~t aed I~~b~
and am aad bave been a bona fide restdent at tbe SW,e d Fbrida sinoe D 2~- / o - ~9f~D dq d
~9~.inatr~deat C~384 vvn sPf $/~~
18t~t ~ed Naeb~d
~ ~"c~r~' ~ieN~.e = ST. LUGIE ~,~~,
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and this stakment is to be taken as m~ deelaratios ai dtisen~hip. actual kgal residenee and domieDe ia tLe State d Floeida.
' If POR THE PURPOSE OP ENROLLING
CHIIOREN IN SCHOOL~ PI.EASE STATE
THEIR NAMES:
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iF FOR NOMESTEAO PURPOSES~
PLEASE CHECK: ~
1980 DEC 19 IIM i1= 51
FILEC RIiC ~ECOF~EO
ST.IUCtE CCUNTY. LA_
ROGER POITRAS
CLERK CIRCWT CWRi /~
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aEtna^~E~~nz° _ ;-~ ~--- -
511.163
I FURTHER CERTII~R tbat I w~l register at m~ loal address wben tbe registratioo booi~s reopea, aod eompl~ wkL all
otber reqnirements d a kgal mide~ a[ t~b State.
I F~JA1~R CERTIFY tbat I bsve no lntentioA to retnrn to m~ farmer domia7e. and I jntend to remain ia
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F7o~'jda. per+naneati~.
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ROGER P01 ?RAS. CLERK OF C 1 RCU I T COC~tT ,
ST. LUGIE COUNTY, ftORtOA - ~ •
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BY: -~`~~~. c~ ~ : • , , .~
EPUTY LERK ~
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