HomeMy WebLinkAbout2745Dec{ara~ion ofi Domicil~ and Ci~~z~nsi~ip ~
. ~
S:f 221'7
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUC I E CpU~Vqy, ~1.,pRIDA; ~
Thii is m~ declaration of Doanica'le aad Gtitueaship in the State of Florida that I am filing this da~ in sccordanee. and La
contormit~ a~th Sec~tion 222.17. Florids Statutes. ~
I w as lormerl~ a 1ega1 sesident of _ i,~ )(1 ~'t- Q lr1 , ~~~~ and I
IGti~7) IScat~
resided at ~ a ~~ ~~~ ~. - However, I have ebanged my domicIIe to
(Street and Number)
and am and have been a bona ~ide resident of tbe SlaLe oi Florida sin l 9~~ da~ o[
P r -19~ and I residc st ~~> n•~ ~n-~u~~ S~ .
~sc,~ac ana N~mber~
~~-~ `'~ . ~v. c ~ ~., ~--\a _ , ST. LUG 1 E co~t~. r~oriaa,
ec~e>>
and this statement is to be taken as my dedaration of citizenship. actuallegal residence and domica'le in the State oi Florida.
" IF FOR THE PURPOSE OP ENROILING
CHILDREN IN SCHOOL~ PLEASE STATE
THEIR NAMES:
r--
.,.
IF FOR HONESTEAD PURPOSESi
PLEASE CHECKS ~
1981 Jkti -2 Pt~ I2~ 19
f~LEC ~~C'iCUF.UEO
S ROGER PO TRASA
CIfRK CIRCUIT Ct-UR1
u:rr~:^ ~ ~ , ~ ._.
51221`7
I FURTHER C~RTIFY that 1 wt71 register at my local addrESS vvhen the registration booka reopen, and eompl~ wit6 aD
cther requiremeots of a legal resident of this State.
I Ft71tTHE~t RT'ff'Y that ~ have no intention to return to my lormer domic~e. and I intend to remain in
~ - ~_- 5 T,* L U G 1 E Count~.
ICrt~) .
Florida. permanenti~.
J\,~ & COVN
c~ . : •~ ••....~. r {. ~~
C :' `~`; iid ., ~
~~ ~ . ,~ ; o
~ ~ `, ~.~ =~
. , =' ~~ -
- Y ~.. ti~~~
~~ ~e ~(°c~S~~
U
't ~~ c .. c ~ C~..,
~., n ~
Sworn to and subscn'bed before me this ~ da~ of_ ~~~~-
~ ~.D.. / 98/
ROGER POI TRAS, CLERK OF C i RCUI T COCfi2T ,
~. ~1F -~-cr~ ~~
(rt.m.)
~u-.~- ~ \
c~aem..~
S~ . ~~,~ P ~ ~G
~ ST. LUG I E COUNTY, f LOR 1 DA •
. .,
- BY: -~ ~ ~ . •
C~~ . UEPUTY I.LERK . ~
~ '
~ a~~~ p~~iZ~
~
' .y '.: . . . Y
- 1a~"` "sip."JT • - _
.:s~il~.a~aS.'r , . 'Tr~~ ..>.. .-.. v
.
.
33~~Z ,~~
..
.~ ~
~ 1
~ _t ,~
' ~
v ~ i9
~i~-~