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• n~ :flECLARATION OF DOMICILE4C7S081
of the Circuit Court Count Com troller) ST. L UCIE County, Florida.
To the Clerk [ Y P ~
This is my declaration of domicile in the State of ~IU rid 0?. , that I am filing
this day in accordance and in conformity with Section ~3:TT,~~orida
~`tatutes.
FOR D~MICILIARIES OF THE STATE OF FLORIDA:
I hereby declare that I reside. in and maintain a place of abode at ~(oQ p? kit V 1.000 Rd.
s rest an n e
F"}". piGrN- , 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 hone,
and I intend to continue it permanently as such. I am, at•the time of making this declara-
tion, a bona fide resident of the State of Florida residing at 3(003 A IC i rbu loop Rd ; ~
-Tstreet an n er
p iCrC~ in s'~, LUC ~ P_ County, Florida. I fo~ resided at
c ty
1-}-q~gy~Q County. U 0. 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.)
485081 t
HAY - ~ PN 01
~ Rl.t:t~testt ~ ~ ?
~ ~ITRASA J O~?
17 C®URT ~ ~ f'
T,
~i~91V ~RtFt£0_.--'_ signature `t<~ir~~~,,i
Sworn to and subscribed before me this day of ; -
~ =
ROG PO I TRp S, ~ ~ .~'r!'~URT
ST LUC I E COUN. ~ 1;i~
~
Y
`rotary Public State o F on a at Large. ~ d' ~ ~ nom=
!~y Commission expires BY j' - r., 1~`PI~TY CLERK
FOR DOMICILIARIES OF STATES OTHER THAN THE STATE O
I ereby dec are t at my domic le is in the State of an~that I intend
to permanently continue and maintain my domicile in suc state. At t e timeZof making this.
l 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.)
F '
f
signature
• ~
z .
sworn to and subscribed before me this day of A. D. 19 i
'rotary Pub is State of Flors a at •Large. '
"y Commission expires
t
~ ~ a~330 P~1~4