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DF.CI.ARATION OF DOMICII.E
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~±':e Clerk of the Circuit Court ~County Comptroller) ST. LUCIE _ _ Caunty, Florida.
• i s i s m}' ~'eclarat ion of domici le in the State of •-~~h-z.< n/~.~ , that I am f i 1 ing
t~ s c?ay in accordance and in conformity with 5ection 22~;-I'f,- FToric~.a Statutes.
~. :~?MICIi,IARIES OF THE STATE OF FLORIDA:
'. ~ t ~by declare that I reside in and maintain a place of abode at ~,r<._ r' `-~ /iP x. /:~ rj
Tst`:-eet ~and nun~er)-'
_~f ___l-'~_~ ~«.! ____, in ___ST l UCIF ___ County, Florida, which place of abode I
Zcity~- ~ - -
~;~ize and intend to ~raintain as my permanent home 3^3, if I maintain another place or i
'~~s of ab4de ~;; some other state or states, I hereby declare that my above-described
'.•-nce and abode in the State of Florida constitutes my predominant and principal home,
~ I intend to continue it per~ranently as such. I am, at the time of mak'ng this declara-
r., ~ bona fide resident of the State of Florida residing at _~'~~~~, ~j~ ~~~x_; ~~c~,
{stree~ and number)
- / 1` ~ • \ .- ~t ~ ~ 111 ~ -~~ . ~ i `. . < < r
_~% .--• _____ __ ___ County, Florida. I formerly resided at
(city) ----- ~.s,. _ ~
1_ i~ ~
- "~> 5 r,~.. ~ ~ «~. ,, ~ ~- .~ T~. r°~ ~~ T~: i ~,~• ~Y-. ~a -., ~~-,l~ , anc~ the ,
(city ' ~state) !
<~~. or places where I maintain another or other place or places of abode are as follows: i
=~e ]ist street address, city, county and state of any other place or places of abode.) ~
~..
''~Ct~-!E A RESIDENT ON THE .~_~" 0AY pf. ~,>_~;-'. 19 ~~'t'~i~+»~~~'-
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(signature)
. r. to and subscribed before me this ~` day of ~(,Z~~~ , A. D. 19 ~~ .
~ ROGER PO I TRa S, CL ERK C I RCU I T COU2 T
' ST. Lt1C I E CO NTY, FLOR I Dl-•
f-i_; Public State of Florida at Large. /
-rission expires . Blf ~~,,~_ i~~- ~EP~TY CLERK
U~r
-:'yICZLIARIES OF STATES OTHER TF'.AIJ TNE STATE OF FLORIDA:
~ ~
~~:e~y cPcleze that~my domicile is~in'the State of and that I intend
~-._-.~nently continue and maintain my domicile in such state. At th~ time of making this
~ ._:ation I am a bona fide resident of the State of . My place of
--~- »ithin the State of Florida, if any, is as follows: (Here list street address, city,
I:_u:.ty of place of abode in Florida.)
~ _`.- -akina declaration may also include such other and further facts with referen~e to
~-~ done or performed by such person which such person desires or intends not to Le
~~ :-~ed as evidencing any intention to establish his domicile within the S~ate of Finri~a.)
t981 NP,R -2 P!~ ~ 12
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.r: to and subscribed before me this
~ry~ Public State of Florida at Large.
' ~-.Tission expires .
~
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F~! ~c ~s.t ~~ cwr'E ~
51. IUCIE t G~~v f-Y. ( i 1~
• ROGE'R f'01 i RAS
:lf fiK CiR;,';; i t~ ~
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51bi6bi~
(signature)
day of , A. D. 19 .
~~3~49 P~~,~ 1880
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