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Declaraiion of Domic~le and Cifi~~ilSlli~ ~~
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512378
TO THE CLERK OF THE CIRCUIT COUk'i'.
ST. L UG 1 E ~;pU~y, ~,p~A;
This is m~ deelaration oi Domic~e and Gtitizeruhip in tbe State of Florida that I am 51ing this dq in aooordanee. and in
eonformit~ v~ith Section 222.17. Florida Statules.
I a as formerl a legal resident oi /~~~/UG'' hG /~ ~> ,_ ~1J /~y and I
. 1(~7) IStatd
residcd at l ~~ cS~ Lc. ml~i r c5~ T - Hox ever. I bave ebanged my domici7e to
(Stie~ei aad N~betl ~ ~
and am and have been a bona Sde resideat of t6e Slate of F7orids since ~:~ ~ daT o[
~ /~ ~ • ,~3 /~o~ ~- ~ /,~
~-' ~ r 19~ and I reside at W / ~ ^ ~ ~ ~ ~ ' "-
~ (Stmt aad Number)
~(j l`' ~S T- I~ lG ~. ~~~ ~ ST . L l1C I E Count~. F7orida,
1(~it7)
and this statement is to be taken as my detlaration of citiunship, aduallegal residente and domidle in the State oi Florida.
' IF FOR THE PURPOSE OF ENROLLING
CHIIDREN IN SCHOOL~ PIEASE STATE
THEIR NAMES:
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F~~tc tht ~~cc~,~ o
s R GER POITRAS~
CLERK ~iRCUiT CCUP.TQ
Qi Cf.R= ! i :qc , ~ ~ _
5123'78
I FURTFiER CERT7F'Y that I w~71 register at my local address when the n:gistration books reopen, and eompl~ wit6 aD
other requirement~ of s legal resident oit~is State.
I FURTHFR CEATIt'Y that I have no intcntion to return to m~ .former
Floridt, permanenu~.
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Sworn to and subscn'bed before me this ~
C~a.~.K.ti-~ . e.D..
. and I intend to remain in
Connt~.
~~~
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/ 98/
ROGER P01 TRAS. CLERK OF C IRCUI T COtd~T_._
ST. L UG 1 E GOUNTY, f LOR 1 OA •
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sY: ~~ ~ry,~~
_ EPUTY LERK
IF FOR HONESTEAD~PURPOSES~ -
PLEASE CNECK: ~
AJ ~'4ed H. Core
~ ~ g~~x345 P~~2983
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