HomeMy WebLinkAbout09520
~`
~ ~
DEC:.ARATION OF DOMICILE ~J1pQ~9
To the Clerk of the Circuit Court [County Comptroller] ST. Ll1CIE County, Florida.
This is my declaration of domicile in the State of , that I am filinq
this day in accordance and in conformity with Section ., F ori~a-3`tatutes.
FOR DOMICILI7~RIES OF THE STATE OF FLORIDA:
I hereby declare that I reside in and maintain a place of abode at ~J~ ~„s w/l ~~~ ,.., ~~~r~ ~~.
-~tree~ a~nu r)
~' -' ,t , in STr ~ UCI~ County, Florida, which place of abode I
y 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 predominani and principal home,
and I intend to continue it permanently as such. I am, at the time of makinq this declara-
tion, a bona fide resident of the State of Florida residing at ~/d ~.t..~ ~ `~~~~=1°
Cstreet an n r~
`•c' ty - ~ .
. ~ '~ _ r ~ z s ~n ~ :~ ~ . . , .r Count_y, Florida. I formerly resided at
- .. ,t~~,~,,~qa~_ ~ . ~ t ~ County, ~,o,~ ~ ~ . and the
. : ty ,_~~...}~"-~ - _~__.~~ state
~lace or places where I maintain anothet 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 1_. ~.~ ~~~'1~1~' i? . : _
: .~1,P/1,ti ~ i:~L ~n . ,l~r ~ ~~ i 5 ~" /
~~
~ sworn to and subscribed before me
this~~~~j day ;
of ~
, A. D. 19 ~.
f ROGER POI TRpS, CL~,Rf4,~W~iAG~,~T GOl~2T
~ . ST. LUC I E COUNTY
~~~E~D~';`~!~~. .
i'.o~ary Public State of Floric~a at
; Large.
~ e
`•~?'.•''~ '• ~•~'~•
~LERK
- '' :'-• "DEP~;'Y
M.~ Commission expires . ._
_ .
%
.
~ .
i.
L. .
~
.~
~'OR DOMICILIARIES OF STATES OTHER THAN THE STATE OF ~ r. ;
; . ;
' Y 1 :
, - ;cn ~' r-•~ ~ . -
~~~
~ nere y ec are t at my omic le is in the State of ~tiact~,:~tntend
~~'-,.'•=
` ta permanently continue and maintain my domicile in such state. At ~t~ ~E~ this
` ~
~~~
~
~ declaration I am a bona fide resident of the State of .of
-;
: i
i abode within the State of Florida, if any, is as follows: (Here list se.'t'~et dress, city,
! and county of place of abode in Florida.)
'Person making declaration may also include such other and further facts with refezence to
a:~}~ acts done or performed by such person which such person desires or intends not to be
~onstrued as evidencing any intention to establish his domicile within the State of Florida.)
s~~
l~~i E~~ 25 f:': ;~ Ct r
sj'L~~i:, '_i:~~4~" V
FGu:r -'- '" • \
~__'~,Y ~
\
J i
. .!~/ ~
/ _~ ,_,~~~~ /~ r~ ~. ~- <~ ~
~ ~Zsignature) /
;. (/YI~C~~L)
(signature)
~.worn to and subscribed before me this
day of
, A. D. 19
~ ~:otary Pub~ic State o~ Floric~a at Large.
~ M;~ Commission expires .
~
~
~!!~1K•,~~ F~b'E ~V~
~
? ,.
~ ~~
~
~~:~~~r_~-~~.y.. ~~. _ ., .. ~_. .. - .
~
~ -- :.. _ r :::~