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484816
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' • nb$~LARATION OF DO~MICILB
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To the Clerk of the Circuit Court [County Comptroller) ST. LUCIE County, Florida. '
This is my declaration of domicile in the State of ~ , that I am filing
this dap-in accordance and in conformi>~y with. SectioiTi , or a tatutes. 1
FOR DE~CILIARIES OF THE STATE OF FLORIDA:
i hereby declare that I reside in and maintain a place of abode at
____.~~.~1 , in ST. LUC I E County, Florida, whichrplacenofnabode I
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recognise and intend to maintain as my permanent bane and, if I maintain another place•or j
places of abode in sane other state or states, I hereby declare that my above-described
residence and abode in the State of Florida constitutes my predominant and principal•hane,
and I intend to continue it permanently as such.. I am, at the t e of~~makin this declara-
tion, a bona fide resident of the State of Florida residing at ~Lr ,
s ree an n er '
in Gt,.~i County, Florida. i formerly resided at
~ c ty ~ ~
~ , ~ County, Ct/ , and the
c ty sta e
glace or places where i iaafntain 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~/mot
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s gnature ; yt~
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Sworn to and subscribed before me this ~ -day of , Af D:atl
.7 ~ ; '
OGER P01 TRA S, Cil.. ~ •~C 1 RGU-I T.= ~QUR T
S LUG I E COUNTY' • ~C~t~l. ' ' ' `
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Notary Pu ~c State o F on a at Large. s'•% ~,g • -~~'r
My Caamaission expires BY " . D~`•P ~1,P~r G L E R K
.
FOR DOMICILIARIES OF STATES OTHER THAN TAE STATg OF.
er y ec are at my omsc e s n the State of and that I intend
to permanently continue and maintain my da~nicile in suc state.. At t e time of making this
declaration I am a bona fide resident of the State of My place of
abode within the State of Florida, ff any, is as follows: ere 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 datnicile within the State of Florida.)
_484816
- 1980 APR 29 P!i 2' 31
F LED ANC R
5~ LUGIE C~LA.
ROG£R POITRAS
alER1S ClRCU(r •
R=EC'D ~'CP.IFtRp
signature
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Sworn to and subscribed before me this day of A. D. 19
notary P 1c State o For a at Large.
My Comtaissfon expires
i
- '~33(l p~iOall