HomeMy WebLinkAbout1247l~~cE~c~a~EO~~ a~ k~ar-~i~i ~ ~r~c~ ~i~i~_c~~s ~if~ ~:
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5148'79
'I'0 THE CLERK OF THE CIRCUIT OOURT. ,
S7. LUC i E ~ ~p~,~y. ~t,pRID~; ' .
This is m~ dcelsration oi Domic~t and CHiseaship in tbe Stat~e oi Florida that 1 am fiting this ds~ ia ~aordanae, u~d [s
coz~ormit~ R-itb Sectioa 222.17. F7orida Statutes. -
• ~ r~ ~ l~! h o M and I
I~•as formerl~ a legat resident of ~,/'1 ~ C A~
l(~71 lstaid
m s; ded at ~~ ~ 9 ~• ~ ~ HoR ever. I bave ebanged m~ domic~e Lo
IS•.~aet aad Namber) ~ ~ ~
a ~d nm and ha~ e been a bona fide resident oi tbe State of Florida sina l~- da~ at
____~~,(,~ _ 19~. and I reside at __,~~ s1i /~/ ~ t1Y1`_
I (Street ~ umber)
-- ~ c~--t -~~ ,~ C ~ E ST . l UC 1 E Count~, FJorida,
Itxt7)
snd thss statement is to be taken as my deetaration of citiunsbip. actual Iegai residencr and domirile in tbe State of Florida.
" 1F iOR THE PURPOSE"OF ENROLLlNG If FOR HOMESTEAD-PURPOSES~ ~
CIiiLDREN IN SCHOOL~ PLEASE STATE PLEASE CHECK: ~
T HE 1 R N/IMES:
Iq81 JAN 26 P~; 12~ SS
FILEC ~Nf ~~ ~UNt~: F
ST.LUCiF' CCtl~iiKFi;.
ROG~R P01 i R115 ~1
' CIERK C1R~tri "~~]~
p[r~='. , ~ • , , t
. ~ 5148'79
I FURT~R CERTII~'Y tbat I~11 register at m~ local address when tbe rrgistration books reopen, and eompl~ w~itb aD
o:her requiremeats od a Iegal resident of this Stat~e. .
I F[JRTHER CERTI~'Y that I have no intention to return to m~ former domic7e. aod I intrnd to nmsin in , ~
, ST * L U C 1 E . , Count~.
((~tT) _ • _
~o:ic~a, permanenti;.
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ROGER P01 TRAS* CLERK OF G IRGUI T COCd2T
ST. LUGI E GOUNTY, fLOR 10A •
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