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=DECLARATION OF DOirIICILE
To the Clerk of the Circuit Court [County Comptrollers ST. LUG I E County, Florida.
This is my declaration of domicile in the State of FL~o? , that I am filing
this day in accordance and in conformity with. Section~'~~I~ar~da 3`tatutes.
FOR~OiMICILIARIE.S OF THE S?ATE OF FLORIDA:
I hereby declare that I reside in and maintain a place of abode at 2;so! 6R~?Y ~W1~ LAwG ,
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P in ~ ST. LUC 1 E County, Florida, which place of abode I
c .y
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 co~,i.nue 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 t~b9 r.L~?Y •~W~ ~ i
s ree an n r
~o~ rte , in sT. L.yc~E County, Florida. I formerly resided at
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a.w~ cww,ztE sTdu County, sa~iTM . cue and the
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place or places where I maintain another or other place or places of abode are as follows:
(Here 3ist street address, city, county and state of any other place or places of abode.)
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signature
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Sworn toscribed before me this o~"~ day of~ , A. D. 19 8~.
,K ~~~4 _ ROG - P01 TRAS, CLERK CIRCUIT COURT
- ~ ST. LUCiE COUNTY, FLORIDA
• For} ay at Large.
My7~ ~ scion ~ t~ a 18/8`f BY DEPUTY CLERK
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FOI~ . . ~ STATES OTHER THAN THE STATE OF FLORID~I: -
t my omic e s the State of and that I intend
to perl4~ ~ ~`atinue and maintain my domicile in suc state. At a time of making this
declarat ~fi;!~t.:~n a bona fide .resident of the State of I~ty place of
` abode wit ~n~the State of Florida, ff any, is as follows: Here ist 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 domicile within the State of Florida.)
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1960 H!~Y 22 ~ ~ 12
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signature
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Sworn to and subscribed before me this day of A. D. 19
Notsry is State o For a at Large.
My Commission expires .
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