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485048
rl~ ~:flECLARATION OF DOMICILE i
i
To the Clerk of the Circuit Court (County Comptroller] ST. L UCIE County, Florida.
This i8 my declaration of domicile in the State of ~ that I am filing
this day in accordance and in conformity with Section's 7, FI~orT~a 3`tatutes. ~
FOR LSb~MICILIARIES OF THE STATS OF FLORIDA:
/
1 hereby declare that I reside in and maintain a place .of abode at 3f~ c.EZr C -~~~'.2~ ,
s ree an n er
~ ~-C~~ , in ST. LUC I E County, Florida, which place of abode I
city }
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 dune f makin is declara-
tion, a bona fide resident of the State of Florida residing at •'4•~c_~ ~ , is
street an n r
<o~'~,~~. /~c-vc~c~- , in County, Florida. I formerly resided at
city ~
j'~J - • .7jec~~c~, County, and the
city state
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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signature
Sworn to and subscribed before me this ~ day of ~ a.-„ A. D. 19 s'4 .
ROGER PO I TRA S, CLERK G I RGU I T COURT
ST. LUG I E COUNTY, FLORIDA
i *lotary Public State o Florida at Large.
{ FSy Commission expires BY.~ ar!~~ DEPUTY G l E R K
F'OR DOMICILZARIES OF STATES OTHER THAN THE STATE OF FLORIDA:
~ I ere y ec are t at my omicile is in the~State of and that I intend
j to permanently continue and maintain my domicile in suc state. At the 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 domicile within the State of Florida.)
485048
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REtORE~ VERifiED__~-~---
signature
g sworn to and subscribed before me this day of A. D. 19
'rotary Pub >`c State o F on a at Large.
~:y Commission expires
s_. _s _ .