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51`7'713 ~
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To the Clerk o` the Circuit Court (County Co:-ptro' ier? ST. LUC I E Cosnt}•, Fic:ics.
T~is is m}• deciaration o~ no:nicile in the St3te o~ ~~Z,~C~~ , Lh~~ I ar., fi:in~
tr:s da~~ in accorca~ce an.a. in conforn:ity Mit~: Sectior. ~'l'c.~r, Floriaa Sta~u~es.
FOR D'~MICILIARZES OF ^.'HE STATE OF FLORILA:
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: hereby dec~.are that I resiQe in and maintain a place o: aboae at ~/ ~~ /~o,~..,~nw./t:,~_
~ ~~` ~ - " t stze _ ~ ar.c r.~ ..:~er; `
'~~~ .~. ~-'~u-c. c_ ~= , in $?. 1_ ~)~ :' Cczn:~•, Flori~a, which zia~e of a:.o3e Z
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~eco~nize aa~ :nten~ zo r..3intair. as r.~• p~- -_~.~::`_ .._.--~ a^:, i' I r:.=_'_n:ain a-__ _:._- r:>-~ cr
_ iaces of abone in some othez state or s~ates, Z i~ereb:• ceclare t:at my a`~•. _-~~ s::z-:~=~
:Qsidence and abode in the State of Floricia ccr.s~i=utss r..~~ predor~aant ar.~ ~r;:.c;-:ai ~~~e,
and I intend to continue it permanently as s~~'r.. I a.T, at the time of maxir.? ~: 2s ::~c~~ra-
:.ion, a boaa fine resident of the State of Florica residing at ,3 j- , / ~{1~-j .
~~ l street a.~c :.~~r~er ~
~~~ . _ . , in ~ ,>y,wc.~~ _ Count} , Florida. I forrr~rly zesi~ed at
city : ~~ , ~= _.. -
,
~"j ~ o , „~ County, ~~~.~r~ ,- ~_. and the
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-:ace or places w~ere I maintain another or other place or places of abode are as foZlo~s:
;=~ere list stree= address, cit}, county and state of any other place or places of abode.)
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Swor~~~~~ 41su~~ before me this 19 day of February . •, A. D. 19 81 .
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MYtC ~ 0~. ~. ~ +~~Jo} rY Pu~R'c, S`~a-e o~~Tda at l.a-9s
_ e r'-7T~lw -' Gt. Z3• ~484
ROGER PO I TRA S, CL ERK C I RCU I T COURT
ST. LUC I E COUNTY, FLO4 I Op .
BY
DEPUTY GIERK
~. --qlu.~- _^~~ - m~ ~~"'------ -
FOR DO •.dF ST~TES OTHER TAAN TAE STATE OF FIARIDA:
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I ereby dec are t at my omicile is in the State of and that I intend
~o permanently continue and maintain my domicile in sucn state. At the time of makinc this
~eclaration I am a bona fide resid~nt of the State of . M;: olace of
~~ode within the State of Florida, if any, is as follows: iHere last street aadress, city,
an~ county of place of abode ir. Florida.)
;Person making declaration may also include such other and further facts with reference to
~~y acts done or perfor.,tied b}• such pezson w::ic:: such person desizes or intends not to b~
~onstrued as evidencing any intention to establish his oomicile within the State o: F1^::da.)
1981 F~~; 23 ~,~ t ~. 2^
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S1~'713
lsignature)
sworn to and subscribed before me this
day of , A. D. 19 .
tiotary Public State of Fiorida at Larae.
"!y Comr,:ission expires .
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e~ 349 P~~ 242
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