HomeMy WebLinkAbout0214
~eclaraiio~ o~ Do~~icile and Cifiz~nst~i~
~ ~ ~ S~ ~5~3
TO THE CLERK OF THE CIItCUTT COURT.
ST. LUC 1 E Cp~y, r-I,pRIDA;
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This is my deelsration of Domica'le and G~tizens~ip in the State oi Florida that I am filing this da~ in aocordance. and in
coniornut~ R~tb Section 222.17. Florida Statutes.
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I w as formerl~ a 1ega1 resident oi ~-
~ I~t~1 (S~tal.~)
resided st ---1~.cP • `~i~ NoR ever. I bave cbanged my domic~e to '
(Stise~t aad Nmnbe~ - ~
and am and have been s bona Sde residcat of the State of Florida since '' ~ day at +
-19 ~o v - and I reside at ~ 3 •~- a2.7 ' /~~~-~ ' ` ~'„PJy ~~d~t~G_~S~
/ V ~ lSemt aod Numl'~~r)
/ ~i~ - ST. LUG I E Count~. FJorida.
(~h)
and this statement is to be taken as my declaratioa of citizenship. aetual legal residence and domic7e in the State oi Florida. s
" IP FOR THE PURPOSE OF ENROLLING IF i0R NOMESTEAD~PURPOSESi ~
CHIIDREN IN SCHOOI~ PI.EASE STATE PLEASE CHECKt ~~
THEIR NAMESS .
19~ JA~i -7 I~HH i~ 1 I
F~~EC ~NC ~~caRa a
ST.LUCIE COUlI~Y fld.
ROGER POITRns
CtERK ClRCUI1 CGU~jn
RS~L~; ~'~ E', ' ^ _ ~. ~---
S~ 2523
I FURTHER CEftTIF'Y that I w~11 register at m~ local address v~hen the registration books reopen, and eomply ~ith aII
other requirements of a legal residenL of this State.
I FtTRTHE~i CEBTIFY that I have no inteation to return to m~ tormer domic~e. and I intend to remain in
~-i,a~-~~--~--~ l`3~~.~ ~~ --,- 5T * l. U C i E , Count~.
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F'lorids. permanenu~. ~
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h (AdBresa)
Sworn to and subxn'bed before me this - 1~ da~ oi
w.n._ /98/ ~v~~~-i~, ~ C munQ~>.
ROG R POITRAS~ CLERK OF CIRGUIT C0~2T ,
ST. L UG 1 E COUNTY, f LOR t OA • t•
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BY: • . ,~
` EpuTtr ~Ea~ .'
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~ BOOK~~~ PAGt ~~ - . . "
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