HomeMy WebLinkAbout1490sa.84zz y~ ~
AECLARATION OF DOMICILE
--------- .
_~he Clerk of the Circuit Court [County Comt±roller) ST. L UCIE County, Florida.
'~is is my declaration of domicile in the State of ~~~ r~ ~/ ~' , that I am filinq
~:is day in accordance and in conformity with Section ., F ori a Statutes.
~:R DO*9ICILIARIES OF THE STATE OF FLORIDA:
~,~•: eby declare that I reside ~in and maintain a p2ace of abode at 9-9 4'° S, ~~ A,
_Jc='~'15~1~ ~~~ic.`{ LMUO~'~r n Co,~ street an n er
: in ST. L UCIE County, Florida, which place of abode I
_ _-_~.c i ty _
=-~~o_nize and intend to maintain as my permanent home and, if I maintain another ~lace or
;ac.es of abode in some other state or states, I hereby declare that my above-described
___i~ence and abode in the State of Florida constitutes my predominant and principal home,
~d 1 intend to continue it permanently as such. I am, at the t' o making this declara-
ion, a bona fide resident of the State of Florida residing at ~~~0 ~. A'1 /~ ,
~~~~ /~ `~ r_/ ~ ~; ~ / street an num r
~J ~' II S~~'h , in~r1 ~ ~r. ~- r/~ounty, Florida. I for~r.erly resided at
(city • • / ~:.~y.-z
1~~ ~~~R fX'~i c. ~ , Vp ~ Gt S f~- County, ~~~ Y'~U ~ , and the
~(city state ~
'_ace or places where I maintain another or other place or places of abode are as follows:
:ere list street address, city, county and state of any other place or places of abode.)
~~EC~ME A RESIDEMT ON THE JI pAY OF ~ u ~,' 19 ~5 .
r
~~
~ ~ 'r- ~. / iI~_~U
/ C l ~ i~ ~on 1 e w
signature
-:~rn to and subscribed before me this ~ 7 day of ~f~,
~=~~r-}• Public State of Florida at Large.
.• Co.,u-rission expires
~~-
A. D. 19
ROGER PO I TRA 5, CL ERK C
ST. LUC I E COUNTY, FLOR
Br (~,~1. /_'fIQ..~~
`ti~,;.,,..... .~ ~
r
~.
.~- • -
~
~~ ~i .
~e ~,
~ .
r
~couR r~ . ~
,,
i ~ - ' ~':4,.
~y., L~~~~'i~
f~,- _ -
i': P D~MICZLIARIES OF STATES OTHER THAN THE STATE OF FLORIDA: ~° ~.. :.. ''' ~
~
-e-eby declare that my domicile is in the State of and that I intend
j-...e r.-,anently continue and maintain my domicile in such state. At the time of making this
~laration I am a bona fide resident ~f the State of . My place of
-~~~ within the State of Florida, if any, is as follows: Here ist street address, city,
~-. a~county of place of aboc3e in Florida. )
~:i-_son n~aking declaration may also include such oth~r and further facts with reference to _
:~ acts done or performed by such person which such person desires or intenas not to be
~-___ued as evidencing any intention to establish his domicile within the State of Florida.)
~~~I 1_, 2 f r. ~' ,_ ~
:__. _
~;~rn to and subscribed before me this
f-~azy Pub ic State of Florida at Larqe.
i •, Co.^i.~nission expires
~ ~i : i G4~ - _
~: 1~1: r~-•~• ~ .
f;i Cai .,f'' il` •
~~~'.f ~ t• - ~
_ ... . ~ ~
518422
signature
day of , A. D. 19
''~349 P~~fi490
a~nx
~
;
~
. : : _ ,.
~r~_ ,, .~ _ _ ~ _ . -
. ~
-- _ ~
_ ~#