HomeMy WebLinkAbout2078 O~Iira1~OA OI OOIIIiQiI~ alld CIlliMShi~l
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203:~92
Sl. tl1C1E COl1NTY. FlOR10J1:
This i: my dsda~ation of Oomicil~ and pti~hip in th~ St~h of Horida that i~n Rlinp this day in aooorda~x~ and
in oonformify with Chapter 2Y2. S~ction ?2Z.17, Horida StatuNs.
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1 was fo~ly a le~al hsidsr~t of ' ~ ~ • ~ / ! ~
KitY) lStat~)
and 1 rosided at S~f~iyA N C~D ~4 . I~bvwwr 1 havf thsip~d my domkil~
(StnM and Numbe~)
fo ~nd am and have bae~ a bona fid~ hsid~nt of ths Stab of flo~ida sinoe i~%'/~ ~ ~ d~y ol
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FORT MERCE. SAMrT LU~ COUNTY, ROR~A ~
and this stateme~t is to be taken as my deduation of atinsnship, actual lepa! residenoe and domicile in ths Staie of Flo~ida.
pnse~t here any pertinem facts. such as ssle of property or bu:iness, or reli~quishmeot of emp{oymsnt
st tormer domicile, rorraval o~ family t~o new domicile. pund~sse af home, alc.)
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f11E0 ~ND R~~pRQ~0
' iL LUCIE COUNTY FtA,
r ROCER PpITIlAi
~ CtERK CIRCUIT COIIRt
RECORD VERIFIED ~
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1 FURTHER ~HtTIFY that I wi0 oomply with all oth~r nqui~~n~nts of • Ipat r~id~M of fhts Stat~.
I FURTHER CERTIFY that 1 have no intentan to mtum to my former domiqle, and I inte~d to ~emain in fORT
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~ RIERCE, SAINT LUCIE tOUNTY, H.ORIDA, permar~antly. `
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~ ~„~si?:~:;rti~,f-'~.'_ : (Address)
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~ - ~.:.:4,5 ~j 'ai~~ibed before me this ~ day of 19
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flOURT Notary Publk
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~ By D.C. My Conwnission ~xpiros ~
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