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485848
- - ~•:flECLARATION OF DOMICILE
To the Clerk of the Circuit Court [County Comptroller) ST. L UCIE County, Florida.
This is my declaration of domicile in the State of ~ L , that I am filing
this day in accordance and in conformity with Section F oriTa
Statutes.
FOR dbNlICILIARIES OF THE STATE OF FLORIDA: •
I hereby declare that I reside in and maintain a place of abode at /5'n(e ~yQ. c~ r
street and n er _
F t'• h~? 2AC~ . in _ ST . L UC (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 time of making this declara-
tion, a bona fide resident of the State of Florida residing at 15O1p ~V ~ , i=
street an n r
~1- , p~ 2A.c~ P • in S-~' , LuC, ~ Q~ County, Florida. I formerly resided at
-_~aity ~
A-~--la?a~--a. FU ~ c~ n~ County, and the -
city state
place or places where I maintain another or other place or places of abode are as follows:
(xere list street address, city, county and state of any other place or places of abode.)
s
1980 NAY -7 PH 4= 58
. 3
F~IED ANC F= CE3~iUf D ' 3
• S _lUClf CCUNiY.FI A. ~ ~ ~;~v~;~,~'~
ROGER POITRAS ~ - ~`~..'~~~'`sf~jr` i
d.ERK CIRCUIt C~UR~ ~ , ~ ~ - - ~ ,
_ ,
signature : Y
48S848
~..~y,i-~.y
Sworn to and subscribed before me this ''day of /~J~ sy , A. D. 1~(Z.
ROl;ER P01 TRAS, CLERK ~iRCUI T COURT
S LUG I E COUNTY, FLOR I GA -
':otary Public State of Florida at Large.
t
'41y Commission expires BY _ C OE PU T Y G l E R K
~ FpR DOMZCILIARIES OF STATES OTHER THAN THE STATE OF LORID ~
r
f - t
z ere y declare t at my domicile is in the State of ~j„_ and that I intend
j 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 ~-L.,. My place of
abode within the State of Florida, if-any, is as follows: ,Here ist street address, city, i
! 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.)
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~'•~:orn to and subscribed before me this day of , A. D. 19
- - - ~ - -
°otary Pub is State of Florida at Large.
Commission expires
~`R33O PAGE20UJ
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