HomeMy WebLinkAbout1379. +~ `~
i~eclaraiion of Do~icile and Ci~iz~nship 1-
' ~ 516~'23
~ S~ ~5~3 R~-~ec~l
TO THE CLERK OF THE CIRCtJ1T OOUAT.
ST. LUG 1 E apU~y. ~,p~~; '
This is ~ declara!ion oi Domic7e and (.~itiunslup io tbe Seate cI Fbrida that I am Stins this da,~ in aooordance. and b
oonformit~ ~vitb Seetion 222.1T. Florida Statut+es. ' .
I~ras former s Iegal resident at ~~ ST `' O~G ~~ ~DO W ~~ ~ s S• and I
f., ~ IL'W) • (StaW
resided st ~, w~ t~~` ~ 1~F - Howevet. I bave ~anged ~ domia7e ts
(Stre~et aad Nmsbe~ ~ .w,~
and am and have beea a bona Sde resideat oi the State of Florida ainoe ~~ da,~ d
~, S~S T~NNEStf ~R~~~ ~NE'rrcFSl
~Et~~,~L-.19 andIre9deat LSLA~of
I8t:e~t aad Numb~tl
1"t e.l S~'~1 ~E1ge ly 3 3~} S 7 _ sT. Ll1G I E ~ c~4. ~aa.
«~~ -
and t6is sLatement is to be taken as m,~ dee4ratioa a[ citiunship, adud kgal resideaoe and domiale in t1~e State d Flarida. ~
' IF FOR THE PURPOSE Oi ENROLLIN6
CHIIOREN IN SCHOOL~ PLEASE STATE
THEIR NAMES:,
. ,,
IF fOR HOMESTEAD-PURPOSES~ -
P~EASE CHECK: ~
r-
~81 JAN -7 AM !I~ 13
' ~r
' FiLEO~ crCOROtD
SL li~~.~~ CQIAI T Y. R A_
. ,, ~ ROGER POITRAS _
CLfR!( t~."t~7 COIxiT
R!'Cf~tC ~TRi: ~f ^ - - -
~,~.~ 7 . - 5] 2543
- ~, C,~'.~-- ~~ ~~
~ ~ B~ ~gFo ~ ~
~ To ~ ~~ ~Qu~ ~, !g 7 9
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I FURTAER CERTII~'Y that I wn~l register at m~ local address ~vben tbe segistratioo boo~cs ' a8
other nquirements of a kgal re4ident at this Staie.
. _
- ~ ,.
I F'URTI~R (:EHTffR that I have ~~uo~ ~ nt~ e~ ~ i~ ao~. t;~na n~ n
_ ~e,-~s~ F~~ s~>> . u~ 516'~'~?3 ~.
~ria~, ~~~Da;. 1981 FE8 12 Be-£ec^t~
~M ~ 54
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SL LUCIF C1U.v;Y Ft~_
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~ S~vorn to and sobsa~bed before me t~ ~ daj d ..
' -^ -
A.n._ / 98~ J~/ta P. G~e6A
~ ~ , .
~ ROGER POITRAS. CLERK OF CIRCUtT COC~2T
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ST. L UG 1 E COUNTY, f LOR t DA • .. ~
. ~_ .
. .~~
- BY: ~ : - . . ~
EPUTY LERK '
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, B~(~YO P116E~J~ 30+~e~.'~ P1~6E ~ ~. - . :.-..
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