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_48'1801
- .~ZI~~:DECLARATION 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 that I am filing
this day in accordance and in conformity with Section , or a tatutes.
FOR~OMICZLIARIES OF THE STATE OF FLORIDA:
I ereby declare hat I reside in and maintain a place of abode at ~ ,
ree an n er
, in ST. L UGIE 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 f making this,declara-
tion bona fide resident of the State of Florida residing at ~j_~p s
~ stree an nw er
in County, Florida. I formerly resided at
c t
County, L ~ !V ~ and the
ty sta -
place or p aces where I maintain another or other place or places 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 ~11Q,.., , A. D. 19 O
ROGER POI TRASj CLERK C IRGUI T COURT
ST. LUGIE COUNTY, FLORIDA
Notary Pu 1c State o F on a at Large. -
! My Commission expires BY~}~c.~ ~ - DEPUTY CLERK
f
FOR DOMICILIARIES OF STATES OTHER THAN TAE STATE OF FLORIDA:
f ere y ec are t t my omici a is in the State of and that I intend,
? to permanently continue and maintain my domicile in suc s e. -At t e time c?f making this-
declaration I am a bona fide resident of the State o-f My place of
abode within the State of Florida, if any, is as follows: ere ist eet a ess city,
and county of place df in F],prida' l~ /lJ0 ~'GL1 ~~~u~ ~ ~~`~~~~Z~
{Person making decl ration may also inc de suc~ they 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.)
~ 48~8~~
198D t:AY 28 A~3 i l= 3,4.
FF~I. EC A'u: 66s4s: U
ST.L!lCIE CCUYTY.FI A.
ROGER p017RA5
fEiERK CIRCUf7 CSCitT' ~ ~
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signature
Sworn to and subscribed before me this day of A. D. 19
Notary P is State o F on a at Large.
My Commission expires
- aa~K X32 PEE • 14 K
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