HomeMy WebLinkAbout2875D~ctaraiion of Dor~icite and Cifi~~nsi~ip
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TO THE CLERK OF THE CIRCUIT COURT.
ST. LUC I E ~p~Ty. ~,p~A;
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This is my declaratioa of Domic~e and Citizens6ip in the State oi Florida that I am filing thIs da~ in a«ordana. and in
coaformit~ w~tb SectioA 222.1T. Florida S:atutes.
I a es formerl~ a legal resident oi ~y~~ ~~- ,~~/~~m~n~ ~ and I
1(~7) lSt+t+)
resided at _~D ~~ ~~~~e.~ , Hov~ ever. I bave changed my domic~7e to
(Stmt and N~Der) .
and am and have been s bona Sde resident of t6e State of Florida since ~ da~ d
,19.~~ , and I reside at ~~7
(Street aad Numbee)
~/~ T~• •~l.~ffE' ~t~•~ , ST. LIJG I E Counc~, FJorida.
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snd this statemeat is to be talcen as my declaration of citizenship. actual legal residence and domica7e in tbe State oi Fiorida.
" IF POR TNE PURPOSE OF ENROLLING
CHILDREN IN SCHOOL~ PlEASE STATE
THEIR NAMES:
~eo t~ l.t~, ~/,:~.~ Ge.l, ~le 14~
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I F fOR HOMESTEAD- PURPOSESi ~
PLEASE CHECK: ~
1981 JA~~ -5 P~ i2~ 02
i1LlC ~NC F~CORGfC
Si.luCiE cOU~tY.FI a.
RCGER POITRAS
~ CtERK C:R;,UiT CO t~/
R; C(!R~ 1•F r !f •t * _ ~_I "_r- -- - -
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I FURTHER CERTIFY tbat I v~I register at my local addrest v~hen the registrstion booka reopen. and compl~ with aD
other requirements oi a legal resident of this Stat~e.
I FURTHEA CERTIFY hat I have no inteation to return to my former domic7e. and I intend to remain in
, 5 T* L U G 1 E Cp~t~.
(G~t~) .
F'lorids. permanend;.
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~' ~CDU'~TY .
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Sworn to and subscnbed before me this s~ da~ ~ - ,~.
~a--.~.~ _ ~.D.. / 98/
ROGER P01 TRAS* CLERK OF C IRCUI T CO~fi2T
ST. LUG i E COUNTY, f LOR 1 OA •
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BY: ~~~,u,~ -
C~~~ bEPU~IERK
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