HomeMy WebLinkAbout0372 4t~'79S6
• n~ 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 }-~l?-~,i_~i~ , , that I am filing
this day in accordance and in conformity with Section f~'F:I'1; ~Tori~a statutes.
FOR bOMICILIARIES OF THE STATE OF FLORIDA:
i hereby declare that I reside in and maintain a place of abode at y 1 ~ Sk f
~ r_ ~ in street an n er
_ ST. LUC I E County, Florida, which place of abode I
~~ty
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 ~ ~ .S,f; .~$~r ~ a ~
street n er
~ % ~ : ~ • a-- in ~ = ~ - Q_ County, Florida. I formerly resided at
city- a~
i ~ ~ ~ . " f a. ~ ~t County, ~ ~"1, and the
city state
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.)
J
tt11'' .
" signa re
Sworn to and subscribed befoze me this day of , A. D. 19 •
ROGER PO I TRAS, ~ CLERK CIRCUIT COURT
ST , LUC I E COUNTY, FLORIDA
Notary Public State o Florida at Large. Q 1
My Commission expires BY ~l - I DEPUTY C L E R K
FOR DOMICILIARIES OF STATES OTHER THAN THE STATE OF FLORIDA:
ere y ec are t at my omicile 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
E 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 ist street address, city,
and county of place of abode in Florida.)
i
C
€ (Person making declaration may also include such other and further facts with reference to
x 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.)
~ 4~95b
19:0 r' 29 Fr; 2: 25
?otfCih, r-l:Ga:ii
ROGFt~ i
OITRAS
~ rr, Q£RK CirZCuli C;IL'Ri/f~-
Y
signature
sworn to and subscribed before me this day of A. D. 19
Y
tiotary Pub is State o Flou a at Large.
~ My Commission expires -
i
I~~.~~ 332 p~E X372 ~ s
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