HomeMy WebLinkAbout2230
~-
5189U1
nFCI.I,RATION OF DOMICILE
o the Clerk of the Circuit Court [County Cornptrollerj ST. Ll1C I E Connty, Florida.
'-,is is m}~ declaration of domicile in the State of /~ ~a'bt fLiL
, that I am filing
~,is day in accordance and in conformity with Section 222.17, Frorida Statutes.
'F POMICILIARiES OF THE STATE OF FLORIDA:
~,~ i J ~ ~ /
~;c-reby declare that I reside in and naintain a place of abode at i__ ~~ ~/'v/~'G~~lt ~(~ ,
` "~~ ~7~ /~ ~~~C ~~ (stre t ana nur.~i er)
!(~l , in S T. I.UC~E CQunty, Florida, which p2ace of abode I
~ (city) ~
~-co:niie and intend to rraintain as my permanent home and, if I maintain another olace or
:~~es of abode in some other state or states, I hereby declare that my above-c?escril~ed
~~=:~nnce and aboc3e in the State of Florida constitutes my pre3ominant and princioal home,
-:d I intend to continue it per,r,anently as such. I am, at the time of~ ~king this deS~lara-
ion, a bona fide resident of the State of Florida residing at ~/" (~' /~ t ,y1~G!'_j{l >`~ l~~ .
r • /1,~' ~)~ ~~ _ ~ ` ~ (stre~t and number)
~' ~ l~ ~~~ t~ , in .~~~{ ~`±_~' County, Florida. I formerly resided at
- - (city~ r-- - - -
(city) ~ County, ~state) • and the
'ace or places where I rr.aintain another or other place oz places of abode are as follows:
::~re list street address, city, county and state of any other place or places of abode.)
~L CAME A RE5) DENT ON THE DAY OF ,~~~!%~1 !~~~ 19 L/ ~.
~1 .~:'.'~.. ~t
~~~ ~C ~i ; T~~1. -
_,,~~.. •~_ .-..
,. . r.~
~ . :; ~ ;! ~-. :~ ; i
, ~~: - - ,) - ~ ~ / . ~ ~ j,
~ •_ . . ~' .~J~ ~1_~'~c" ,~-L~~~l~~, ; ~ f-~~t~~~~r
,;~ ~ : ~ ~ ~
~,tj.' ; _ ._ _ `~ /
~t~t _'.'~`~.c~' _ (signature) ~~Ne~' ~(~ntAT(~ ~ep~~~~!
ati~:a ~ /
_rr. to and subscribed before me this y~ day of ~~~~ , A. D. 19 ~.
ROGER PO 1 TR~ S, CL ERK C I RCU I T COUR T
~~ ST. LUC I E COUNTY, FLOR i DA
-~r}• PuDlic State of Florida at Large. ?y ~~
: Cc::.mission expires . BY ~~ (~~/'LUl.C~ti. DEPUTV LLERK
v ~
_~ DJ!~:ICILZARIES OF STATES OTHER THAN THE STATE OF FLORIDA:
:.ezeby ~declaze thatymy domicile is in the State of ~i~~ and that I intend
_ ~~r:.,anently continue and maintain my domicile in such state. At the tine of r^aking this
-~;aration Z am a bona fide resident of the State of . My place of
~~~e within the State of Florida, if any, is as follows: (Here list street address, city,
d county of place of abode in Florida.)
-~~n naking Ceclaration ~say also include such other and further facts with reference to
,~ ~cts done or performed by such pezson which such person desires or intends not to be
-.-:=ued as evidencing any intention to establish his do~nicile within the State of Florida.)
518901
1981 MAR -4 f~l i I~ I 5
~ F~~tt' ~~:~ E: eu~t,rn .
~ S1.lUC~C CCU`ISY.F1~.
ROGFR 1'OITRAS
C~ERK Ci^nC~!1 CC•UFT~
. .. ~ ~ : `' ' ~~
-
i
(signature)
~;rn to and subscribed before me this day of , A. D. 19 .
_a:y Public State of Florida at Large.
Cor.imission expires ,
B~~X•,~e7 F:GE~,~i~~~.e7
.
Q
~
~.~_.-