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' - ; ~ ~b~LARATION OF DOMICILE
To the Clerk of the Circuit Court [County Comptroller] ST. L UGIE County, Florida.
This is my declaration of domicile in the State of /c~f~ , that I am filing '
this day in accordance and in conformity with Section ~ o cTa-3`tatutes. ~
FOR DE~ICILIARIES OF TAE STATE OF FLORIDA:
~ hereby declare that I reside in and maintain a place of abode at iZloD3 QOVC ~T,PFFT ,
s ree an n er
~cF~~LC in ST. LUC I E County, Florida, which place of abode I
recognize and intend to maintain as my permanent home and, if I maintain another place•or
places of abode in some 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 penaanently as such. I am, at the time of makin this deSlara- '
tion, a bona fide resident of the State of Florida residing at .3 ODS~~ ~Ti°E~/ ,
street an nu er '
f ~ C in ST LClG/E County, Florida. I formerly resided at
RU _f,/EST~' y MO/1~/4'OG-' County, /S/~'yt~ yof and the
c ty state
place or places where I iaintain another or other place or places of abode are as follows:
(Here list street address, city, county and state of any other place or places of abode.)
~i~vE C,~o vc ~q vE
,tip ~"VV Yo~'~ co~r~~' `
a-
sworn to and subscribed before me this a g day of Q~-L- , A. D. 19 ~ .
- ROGER P01 TRA S, CLERK G I RCU i T COURT
ST. LUG I E COUNTY, FLOR t DA
Notary Pu 1c State o F orida at Large.
My Commission expires B Y ~-~a ~~u~ DEPUTY C L E R K
FOR DOMICILIARIES OF STATES OTAER THAN TAE STATE OF FLORZDA:
ere y ec are t at my omic le is n the State of and that I intend
to permanently continue and maintain my domicile in~suc state. At a time of making this
declaration I am a bona fide resident of the State of My place of
abode within the State of. Florida, if any, is as follows: Here. ist street address, city,
and county of place of abode in 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 danicile within the State of Florida.)
1980 APR 28 PK ~ 25
F LEO /~11C FFCOHU:0
S~ Ultttt COVtiIY.iLA.
ROGER pQiTRAS
SI.ElfK C(RgNT COUR
RECi:R3 Yip'FIF~A--r-y
~~`t!
signature
Sworn to and subscribed before me this day of , A. D. 19
*~otary Pu 1c State o F on a at Large.
"~y Commission expires
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