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494401
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_DECL~IRATION OF DOMICILS
To the Clerk of the Circuit Court [County Comptrollers ST. LUCIE County, Florida.
This is my declaration of dcmicile in the State of ~L ~ R) ~ ~ , that I am filing .
this day in accordance and in conformity with. Section ~'F:i , or a tatutas.
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FOR w0lIICILIARIES OF TBE STATE OF FLORIDA:
I hereby declare that I reside in and maintain a place of abode at f Jam, y(/ I ~ B~AI~I:
s ee an nu er
O Q ~ _ L P_ / _ , in ST. LUG 1 E ~ County, Florida, which place of abode I
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recognize and intend to maintain as my permanent Name and, if I mai~titain 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 predozlinant and principal haae,
and I intend to continue it permanently as such. I am, at the time of making this declara-
tion, a bans fide resident of the State of Florida residing at N/ C A ~ 1,~~~~,.
s ree an num er
•~/~RT ~T c ty~.~_ f F_ , in - $T L V r) County, Florida. I fo~ resided at
`T y C ~t~ ~"!J L_ c ~ County. ~ 8 a ~ D m,a, and the
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.)
T :Vti
~',reQ s. H B oAZ -
Sworn to and subscribed before me this a9 day of ~ , A. D. 19 ~
ROGER P01 TRAS, CLERK CIRCUIT COURT
ST. LUG I E COUNTY, FLORIDA
Notary is State o For a at Large. r~ ,l
I MY Commission expires BY ~l DEPUTY C L E R
FOR DOMICILIARIES OF STATES OTHER THAN THE STATE OF FLORIDA:
I
i
er y ec are t.my c e s State of and that I intend
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: Here ist street address, city,
and county of place of abode in Florida.).
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~ (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.)
494~~.
t990 ,lU130 III ~ 33
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s STA~O E TRI?S~ -
CLERK COtlitT ~ -
F RECORD YERtilEO
signature
Sworn to and subscribed before me this day of , A. D. 19
•
Notary P is State o For at Large. €
My Commission expires
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