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4135366
~':flECLARATION OF DOMICILE
To the. Clerk of the Circuit Court (County Comptrollers ST. L UCIE County, Florida.
This is~ my declaration of domicile in the State of ~ ~a i , that I am filing
this day in accordance and- in conformity with Sectio '~Floiic~a 33~tatutes. •
roR D~!lICiLIARIES OF TH8 STATE OF FLORIDA:
I hereby declare that I reside in and maintain a place of abode at O~/~ g 5 ~ . ~/~,uk..t. /C~,
!j's ree an numberj_- `
f%,~~ . in ST. LUG 1 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 permanently as such. I am, at the tim f making this d ara-
tion, a bona fide resident of the State of Florida residing at a?/ ~ ~ / . ) #
1 • street an n r
~.~L _ ~ 1 p in ~ . ~ County, Flo/rid~a. ~ I~ formerly resided at f
_ c ty , - ~ County, ~1~~,/[.-<-a~-~ ~ and the
. ~ _ ~.u~ O.
city ~ state •
place or places where I maintain another or other place or places of abode are as follows:
!Here 13st street address, city, county and state of any other place or places of abode.)-
• ;_a- signature
~f~.cuu~~~.` ~eSeNAR)l SNiC~'AR-S
sworn to and subscribed before me this S day of ~~r , A. D. 19 ~ f
ROGER PO I lRA S, CLERK CIRCUIT COURT ~
ST. LUG I E COUNTY, FLOR 1 DA
`rotary Public State o F on a at Large.
My Commission expires BY ~Zu~ DEPUTY CLERK
FOR DOMICILIARIES OF STATES OTHER THAN THE STATE OF FLORIDA:
I ere y ec are t at my omici a is in the State of and that I intend
to permanently continue and maintain my domicile 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, if any, is as follows: Here ist street address, city,
and county of place of abode in Florida.)
iPerson 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.)
19~ NAY -5 AM~iI= 15
P£~~CORpE``O
S~R~pC,EP01TRA5~
itERK CIRCtlIT COURT j
REC11P.9YfRtftE'J.____ cc
485 VV `
signature
~•..orn to and subscribed before me this day. of , A. D. 19
i
i
'rotary Pub is State o Flori a at Large.
'fy Commission expires
3
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