HomeMy WebLinkAbout1307 X86'71'7 ~ ~
a
4-
• n~: DECLARATION OF DOMICILE
i
ST. LUC I E ~
To the Clerk of the Circuit Court [County Comptrollers County, Florida.
this is my declaration of domicile in the State of ~l. tOp , that I am filing
this day in accordance and in conformity with. Section ~~~da Statutes.
Y
FOR ~CelICILIARIES OF THE STATB OF FLORIDA:
I hereby declare that I reside in and maintain a place of abode at /7~ ~ FGO 1e~~A,
s ree an n r
~o Q T S 1'- Ltt G / ~ , in ST. LUG I E County, Florida, which place of abode I
ci~yj
recognias 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 j?g FGe~fS?~+
street an n er
~a Q. s r . G u c r E in Lu t t c^ County, Florida. I formerly resided at
ENc Es GA County, Co ~ and the
c ty sate - _
place or places where I maintain another or other place or places of abode are as follows:
(Here 31st street address, city, county and state of any other place or places. of abode.)
~o ~?A~o o. ~3RfESe E"
~ m
/ -
signature
,~~.~uac:c::f:~;.y
~ j~r:%
Sworn to and subscribed before me this day of , A. Q ~ ,,~,r ;y / :
-aa -
ROGER I TRAS, C~'t`~U, T•;L'`AURT
ST LUG I E- GOUNTI~ ~L . I DA .:-~1~
Notary Pu is State ~o F on a at Large. ~ . _ : ~n~~ :,~y
My Commission expires - 8Y 1~ - ~D~P'(J~~T-.[..LERK
.
FOR DOMICILIARIES OF STATES OTHER THAN TAE STATE OF ~a ? ~ -
er y ec are t at my omic a is in the State of anc'~'~'t"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 1st 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 danicile within the State of Florida.)
'r'
~ 190 MAY I5 PK 12~ 35
a r~cww~a
POITRASA.
~~(CfRCU1T C
KLaIA YERfFiEO_-- ~-~'e~--"
E 4'71'7
~ signature
- i
sworn to and subscribed before me this day of , A. D. 19
r
notary P sc State o F on a at Large.
~ My Commission expires
• _ ------..fo - -