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484905
- ' • ~b$~LARATIOt~I OF DOMICILE + !
To the Clerk of the Circuit Court (County Comptrollers ST.// LUC 1 E County, Florida. ~
This is my declaration of domicile in the State of U ~ , that I am filing
this day in accordance and in conformity with Section , or a tatutes. I
FOR DESRICILIARIES OF THE SATE OF FLORIDA: ~
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I hereby declare that I reside in and maintain a place of abode at (v~b3 /"~<<~~~ H`•
~,P,C- , in ST. LUG I E County, Florida, whichrplace ofnabode I
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recognise 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 hone,
and I intend to continue it permanently as such. I am, at the time of ~~aa~~cci this eclar~}~
tion, a bona fide resident of the State of Florida residing at f~ /0 3 f'~ti•d~..~ ~~°_'G~'
/ s reet an8 nut er
' ~ in ~1 • ~G~.~ County, Florida. I formerly resided at
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County, and the
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place or places where I maintain 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.)
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Sworn to and subscribed before me this day of s , A. D. 19 rl
ROGER P01 TRAS, ~ CLERK-CIRGUI T COURT
ST. LUC i E CO NTY, F'LOR I DA
Notary Pu 1c State o F on a at Large. '
My Commission expires BY DEPUTY CLERK 1
FOR DOMICILIARIES OF STATES-OTHER THAN THE STATE OF FLORIDA:
er y ec are t t my. o c e s n the State of and that I intend
to permanently continue and maintain my daaicile 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: ere ~ st.street address, city,
~ and county of place of abode in Florida.)
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(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.)
1980 APR 30 AM ~ 53
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F EO Ate -
S . LUCIE Cp~1 Y.
~D6ER !'QiTC~t
CLERK CIRCgIT
- RELO~t~I Vf.R:f1E0 ~~L
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signature '
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sworn to and subscribed before me this day of A. D. 19
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Notary P 1c State o F on a at Large.
My Commission expires
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