HomeMy WebLinkAbout1323~~clarafion o~ Don~icile aiid Ci~iz~nst~ip
. ~
51.3101
TO THE CLERK OF THE CIRCUIT COURT.
ST. LUG 1 E
COUNTY. FIARIDA:
/
~~
This it my declaration of Domic~e and Citizeasbip in the State oi Florida thst I am filing this da~ in accordance, and in ~
conformit~ Rith Section 222.1T. Florida Statutes.
I w as formerl~ a 1ega1 tesident oi ~~/~'~ ~~~- , ~C W~~ and I
. ~~~~ ~~
resided at _(~ ~ lL~ ~ t4 ~~ L' ~~ ~ 4" N~ - However. I have cDangcd my domici7e to
~ (Stm~! and Nomber) ~
and am and have been a boaa 5de resideat of the State oi Florids since ~~+ di7 of
J~¢ l~ / ,19~v - and I reside at // U ~~ ~ e ~ r,q~ ~ a v re T .
' ~ _ (Straet s~d Number)
pvRr ~~~ r~r ~ vc ~~ ST. LUC 1 E ~„nh, ~oria.,
tt~s~
and this statement is to be taken aa my declaration of citizenship~ actual legal resideace and domic~e in tbe State of Florids.
" If fOR THE PURPOSE OF ENROLLING
CHILOREN IN SCHOOL~ PLEASE STATE
TNEIR NAMESS
IP FOR HOMESTEAD PURPOSES~ ~
PLEASE CHECK: ~ i
~
r-
.~ 1981 JAN 12 P14 2~ 13
' F~~tc e.~r ~_ca~~rn
51.lU~lE COJ~1 t.FLA-
ROGER POITR~.J 1
- C~EFK CiRCUV i
- ; t:i i:, `,1 = - ' ~ ! --
~ - 513101 '
I FURTHER CERTI~'Y that I wIIl register at my local address vchen the registration books reopen, and eomply w-ith aD
o:her requirements oi a legal resident of this State.
I FURTAER CERTII~'Y that I haee no intention to return to m~ former domie7e. and I intend to remain in
-; 5T ,. L U C 1 E , Count~.
(G5t~1 .
Florida. permanenci~:
,-J~.~•, _ . .
., :~ ~,
.•• ' .
_~;i'• r'- l
• - ,
' ~ /j _
. y~ / / ~''~~
.,L,~~NN~ 1`f• V~~-~R,~
cr~.m.)
llc.~ i~`AC ~ rq Cr
Swora to and subsm'bed betore me this /~ dsy of
_ ~D.. / 98/
ROGER POI TRAS~ CLERK OF C IRCUI T COCfi2T
ST. UGIE GOUNTY, fLORtOA • y
BY: ~ ~
~EPUTY RK
cnaa~..~
I~ _ ~ r . ~ ,• ~ ~ ~ . ~~ ~--. 3 3 ~-- ~ ~
~ ,$~`~x34S P~~E13~.9 ~ ~. . , ~~~
• r •.
: , .~
.
. .
.!.