HomeMy WebLinkAbout0230sZ~~s
DECI.ARATION OF DOMICILE
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To the Clerk of the Circuit Court (County Comptroller) ST. LUC I E County, Florida.
This is my declaration of domicile in the State of ;~ LC'~~i~ /y , that I am filing
this day in accordance and in conformity with Sect~on Z~3;1~, Florida Statutes.
FOR ~Oi~IICILIARIES OF THE STATE OF FLORIDA:
I hereby ~declare that Z reside in and maintain a place of abode at ~~y~Z S[//!~//a~'Q~/~/v~'_
~ T~~e/~' ~ . in ST_ ~UG 1~ County, Florida, whichrplac ofn bode~I
(city)
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 th~s declara=
tion, a bona fide resident of the State of Florida residing at //y~ s~,t~,v Y/lU .
~ ` street an num r)
~~ ~~~ ~C~ ~- , in ~~0~{/c./A County;~ Florida. I, formerly resided at
(city)
~~/lrTA /~ , (~t/ / ~- L County, ~C. ~/ ~/O f~ and the
(city) (state -
place_or places where I.maintain anothez or other place or places of abode are as follows:
(Here list street address, city, co ~ty and state of any other place or places of abode.)
I BECANE A RES I ~ENT ON THE/ ,` ~AY OF ~T~ ,`~ ~ 19 d~ .
~
~ ~ ~~/~~~y`
~ a~ e~l~ h~
(signature
_ . ;~~,C: :..~ ~ j `~'±• ::: -
Sworn to and subscribed before me this .~ ..~s.
p~3 day of 7`-C~ ~ , A;~~''j `~~~~~;.
; ~ ~ ,~__,j ..
ROGER P01 TRAS,~ • ~'C I~ ~:T` URT
N Ll1C I E COUt~ ' ` i4~ .: .x_ ~
o t a r y P u b l i c S t a t e o f F i o r i d a a t L a r g e. £'..., ;~ .~.• ~~
My Commission expires . - ' s~' . ~ C L E R K
~ '
FOR DOMICILIARIES OF STATES OTHER THAN THE STATE O ~~y'' ~•'`•~,}•~~'~•~
,tii ''.
ere y dec are t at my domicile is in 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 f ide resident of the State of . My place of
abode within the State of Florida, if any, is as follows: (Here list 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
ccnstrued as evidencing any intention to establish his domicile within the State of Florida.~)
Sl~''~'05
1981 FE~ 23 ~?~ -!~ ~i.
Fi:.~ c ~~i- :: -:.~r . : -
' S1 ~1)r~r -r~1~'~~.
FiCGEP~f~^1"r~ t ~:
CLE~F~ C;. _ _ . ~
` ~ . 'r~. . ' ~ ~
(/
~ - s,.,. ~ .
~
(signature)
Sworn to and subscribed before me this day of , A. D. 19 .
r7otary Public State of Florida at Large.
My Commission expires .
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8~ 349 ~a~E 2~30
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