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484614
' ~D~LARATION OF DOMICILS
To the Clerk of the Circuit Court [County Comptroller] ST. L UCIE County, Florida.
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This is my declaration of domicile in the State of ~ lp i p01 , that I am filing
this day in accordance and in conformity with. Section , or as statutes.
FOR DdFfICILIARI$S OF TAB STATE OF FLORIDA: ;
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I hereby declare that I reside in and maintain a place of abode at /34/ Gr?,P/a !O' Tel ~ ~y ~
` s ree an n r t
Prc e , in ST . LAC i E County, Florida, which place of abode I
c y
recognise and intend to maintain as my permanent have and, if I. maintain another place•or
places of abode in soaae other state or states, I hereby declare that my above-described
residence and abode in the State of Florida constitutes my predominant and principal home,
and I intend to continue it permanently as such. I am, at the time of making is de 1 ra-
tion, a bona fide resident of the State of Florida residing at /30/ E~ti /c~ t~l ~ •/y
F~ ~ s ree an n er '
,e~G~ in L(JL,'o~ County, Florida. I formerly resided at
T b c ty La ~-p v ~c ~ ~ County, L oWS,Q n ~¦f and the
c y sae
place or places where I maintain another or other place or places of abode are as follows:
(xere list street address, city, county and state of any other place or places of abode.)
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Ec - signature -
Sworn to and subscribed before me this d8 ' day of Q~l,cJC. A. D. 19gd
ROGER POI TRAS, CLERK C IRCU-i T COURT
ST. LUGIE CUUNTY, FLORIDA
Notary Pu c State o For a at Large.
My Cosamission.expires BY Z~ DEPUTY CLERK
FOR DOMICILIARIES OF STATES OTHER THAN THE STATE OF FLORIDA:
er y ec are at my o c e s n e State of and that I intend
to permanently continue and maintain my domicile in suc state. At t e time of making this
declaration Z am a bona fide resident of the. State of My place of
abode within the State of Florida, if any, is as follows: ere st street address, city,
and county of place of abode fn Florida.) .
(Person making declaration may also include such other and further facts with reference to
any acts done or performed by such person which such person desires or intends not to be
construed as evidencing any intention to establish his domicile within the State of Florida.)
484614
• !9~ APR 28 AM ~ 49
FaEe R:c ~o
SL LUCtE~O~!! Y f L•A.
ROCsER
F01 MSt
CLERK C~RCtNT
REC~Ri YERif'IEO
signature '
sworn to and subscribed before me this day of A. D. 19
'rotary P is State o For a at Large.
~+y Commission expires
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