HomeMy WebLinkAbout0561 491584
: DECLARATIOI~I OF DOMICILE _
To the Clerk of the Circuit Court [County Comptroller] ST. LUCIE County, Florida.
This is my declaration of domicile in the State of ~~r 4~ Q~ that I am filing
this day in accordance and in conformity with Sectio I~da'$tatutes.
FORrbOMICILIARIES OF THE STATE OF FLORIDA: ~ / Q~
I hereby declare- that I reside in and aaintain a place of abode at ~D85~ "yG ~Q ` /`~f
L UC / t° in ~
hi
r~~~us~
p/' ST. 'LUG 1 E County. Florida, place of abode I
c y
recognise and intend to maintain as ay .permanent home and, if I maintain another place-or
places of abode in some other state or states, I hereby declare that ay above-described
residence and abode in the State of Florida .constitutes ay predowinant and principal home,
- and I intend to continue it permanently as such. I am, at the tine of making this declara-
tion, a bona fide resident of the State of Florida residing at j~~ Oh~l~/may d• ,
~-f.~7` street an n er
Lt~ci~ in LUCtC County, Florida. I formerly resided at
//3 j,~ ~
~,P ~,n,cr-e t .:~syf f~is l ~ County, ~l tc~ , and the
c ty~ state -
place or places where I maintain another or other place or places of abode are as follows:
(Here list street address, city, county and state of any other place or places of abode.)
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signature
Swos~l.-~o ~an$~;.Rub9c~ibe before nie this ~ day A._ Oi`Y4~~•-;' _
_ r- . r OG I TRpS, G '~l2K _ RCUI~'- COURT
` ' -
LUG 1 E COUN~IC FL I DA -
ot _ o F on a at La e. ~
•s - e~pes DER~t?Y CLERK
FOR ~~°'Q'~"'~~: OF STATES OTSER TBAN THE STATE OF ..R '
~
er y ec are. at my omici e s the State of and~'thaE I intend
to permanently continue and aaintain my domicile in suc state. At 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 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.)
491584
1980 N~ -2 58
f {LEC ?NC ~ CC~~ 4
SiltlCtE CG~TY.fIA_
#~R POITRAS _
ZLERK ClpCtllT COIM .
~'ER'P:~" -
3
signature
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Sworn to and subscribed before ae this day of A. D. 19
Notary P is State o P or at Large. ,
My Commission expires
t X334 P~ 561.
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