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51'~587
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 ~~a~ • that I am filing
this day in accordance and fn conformity with Section 2 , F orida Statutes.
FOR DOMICILIARIES OF THE STATE OF FLORIDA:
I hereby declare that I resi~e in and maintain a place of abode at ~~. ~yue~~lo~ ,
,~ ~ , (street and n er
ip~ ~~. ~ , in $T ~~~~ County, Florida, which place of abode I
ci y
recoqnize 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 const~tutes my predominant and principal home,
and I intend to continue it permanently as such. Z am, at the time of making this declara-
tion, a bona fide resident of the State of Florida residinq at ~a{~ ~ ~. ,
1 ~~,e ~ (street an num er
~ C~~ ~. , in ~, ~v(` - County, Florida. I formerly resided at
~) 1: t~i y) ~
; =~K PC ~ P~ . ~-~1Tdd\P~' x County. ~QSS . . and ~he
(city~ (state)
place-or places where I maintain another or other place or places of abode are as follows:
;xere list street address, city, county and state of any other place or places of abode.)
ti BECANE A RES I DENT ON THE '3~~~o~Y Qf QC~v`~'~ i 19 ~ Q`.
.~~ c~u ;-r`y
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,; ~~.,;;:-~ __ (siqnatur~7
Swern to and subscribed before me this ~ day of ~ , A. D. 19 a~.
~ ROGER PO 11RA S, CL ERK C I RCU i T COUR T
ST. lUC I E C UNTY, FLOR I DA
`votary Public State of Florida at Large. '
My Commission expires ~ . BY_ ~v' " , DE PU T Y C L E R K
FOR DOMICILIARIES OF 5TATES OTNER THAN THE STATE OF FLORZDA:
I ere y ec are t at my domicile is n the State of and that I intend
to permanently continue and maintain my domicile in such state. At the 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 list street address, cit~-,
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 evidencinq any intention to establish his domicile within the State of Florida.)
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51`~58'7
-,. 1931 F.::1 20 ~ n 12 53
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lsignature)
~worn to and subscribed before me this
day of , A. D. 19 .
?+otary Public State of FYorida at Large.
My Commission expires .
an~x 349 pa~E 3 .