HomeMy WebLinkAbout1642 486922 ~ ~
' ~ :~tl~i=DECLARATION OF DOMICILE ~
To the Clerk o>~ the circuit court [County Comptroller] / AST. LUC 1 E county, Florida. '
This is aiy declaration of domicile in the State of RT DA , that I am filing
this day in accordance and in conformity with. Section ~~~~,~P`I~d-a Statutes.
FOR~OMICILIARIES OF: THE STATE OF FLORIDA:
I hereby declare that I reside in and maintain a place of abode at /90a s'~ ' gv~viv0y C~+~-C }
s ree an n r
Po{ t' C ~ ~ , in ST. LUC 1 E County, Florida, which place of abode I
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recognise 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 con~nue it permanently as such. I am, at the time of makitzq this declara- i•
tion, a bona fide resident of the State of Florida residing at q p ~ S t • ~RG~•~•0Y COa.d-, i
oC'~ S~ Ly ~ in ~ ~ C~~T~ ~ s rest an n r
~ , County, Florida. I formerly resided at
c y ~ J ~ ;
j~ Oc ~ c c , -L- ~ SE TI`l ~ ~l ~"r' County, / ~ ~ , and the
c ty -Tsta 'e -
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 , A. D. 1S! :K ~ ='~f;=~
ROGER PQ TRA S, CL _ ~ ~ ~ .
ST. LUG I E COUNTY, F t ,=.~d,.:
Notary is State o F on a at Large. 'o
My Commission expires K
Ij FOR DO!lICILIARIES OF STATES OTHER THAN THE STATE F F IDiA: Ar~•, j, s ~ ~
er y ec are t mY omic a sin the State of and that I"inltend ~
to permanently continue and maintain my domicile in suc .state. At a 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. ere st 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.)
.486922
1980 KAY 19 AN i~ ~ 6
FaEO pfft RfcuwEo
S~.lUC1E COUNrrY.fIA.
11~~GERI POITMS
OLERlt CIRCCIR
signature
Sworn to and subscribed before me this day of , A. D. 19
Notary is State o For at Large.
My Commission expires
. i
X31 P~.~4i K