HomeMy WebLinkAbout0385 ~~b~Ub ?
~':flECLARATION OF DOMICILE
To the Clerk of the Cfrcuit Court [County Comptroller) ST. L UCIE County, Florida.
This is my declaration of domicile in the State of ~ Lo+eiD A that I am filing
this day in accordance and in conformity with Section , F ors a Statutes.
FOR ~ICILIARIES OF THE STATE OF FLORIDA:
I hereby declare that I reside in and maintain a place of'abode at 3v'~~ N A ,
stree an n er
~e•,~e ~ , in STS LUC I E County, Florida, which place of abode I
ci y
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 9x00 /~I A./J!1 . ;
street an num er
T. ~['rc in ~ 'I ~2,,. County, Florida. I formerly resided at
ty
~~jsj~ ~4/hC~f . ~ ~.(~SIL' /f
p,~C~ ? County, e4~ O ~ , and the
city -testate
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 ~ , ~ •t• = ~stir•-s:~
ROG POI TRAS, CL CJ~~.;.i
ST LUC I E COUNTY - c
rotary Public State o F orida at Large. B ' ~'ji~•~'` a - ~~,,`~~`f,,`::~~~ ~
E R K
My Commission expires • _ •.TY~:.. ;
I~ FOR DOMICILIARIES OF STATES OTHER THAN THE STATE DA; _rj~t~tet . -
I ereby ec are t at my omic le is in the State of and that I intend
to permanently continue and maintain my domicile in suc state. At the time of making this
"`i~.r lace of
declaration I am a bona fide resident of the State of My~-p
abode within the State of Florida, if any, is as follows: Here ist streetaddress, 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.)
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signature
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9 Sworn to and subscribed before me this day of , A. D. 19
'iotary Pu is State of Flori a at Large.
My Commission expires
` BOOK~1 PAGE JO~ i
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