HomeMy WebLinkAbout2768D~clarafiion o~ Da«~icile a~d Ci~iz~nsi~ip ~
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51.2231
TO THE CLERK OF THE CIRCUIT COUAT.
ST. LUC 1 E ~p~1~TY, I~-I,pRIDA; ~
Thts is my deelaration of DomicDe and Citizenship in the State of Florida that I am filing thi+ ds~ in acoordapea. and in
coaformit~ witb Sertion 222.17. Florida Statutes. ~
I w as formerl~ a legal resident ot C/aL ~.l N dcl S _ Q N~~ and I
IG~71 lSt+t+I
resided at f,..,.[~e~! I~ oo~ r_ °cl gJ- However. I bave cbanged m~ domie~e to
(Stse~etandNambet) .
and am and have been s bona fide resident of t6e StaLe oi Florida since ~ daT ~
_ TA N~gaY ,19~~, and I reside at ~Q1'~ ~~ ~lI N ST.
(Stree: and Numbar)
fY. e ~eRcP , ST. LUG i E Counc~, F7orida.
tati~
and this statemeat is to be taken as my declaration of citizenship. actual legal re~idence and domic~e in tbe State oi F7orida.
" IP FOR THE PURPOSE OP ENROLIING IF POR NONESTEAD PURPOSESi
GHILOREN IN SCHOOL~ PLEASE STATE PLEASE CHECKt ~
THEIR NAHESt
~
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1981 JAN -2 PM 2~ 28
.~ Fa~e Rc.c «co~to ;
SLLUCIf CCUN1Y.FlA.
RQ6ER POITRAS
CLERK CIRCUII CCtlZi~
~ ?E~CRn ~~Eq~f tc n _. ~-~ ------
- 5]_2231
I FUR1'F~R CERTIFY thst I w~11 register at my local address ~vhen the registration books reopen. and eompl~ witb aD
other requiremenb oi a legal resident oi this State.
I FURTf~B CERTIFR that I have. no intcotion to return to m~ former domic~e. and I intend to remain in , ~
-",- 5T , L U C 1 E , Count~. ;
F7, P~eRce ~c~,~ . `
- t
Florida. permanenr.i;. ~
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Sworn to and subxnbed be~ote me this ~ da~ od /~T. ~~e , F~[ . 3_3¢$~ .
tiD.. / 98/ ~jo ~ c r-x~Rm~.~. ~
ROGER POI TRAS. LERK OF C IRCUI T COCd~T , '
ST. LUG ~ E GOUNTY, ftOR 1 OA •
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BY: • .
ePU Y K
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