HomeMy WebLinkAbout0424_1 ~
519580
DECLARATION OF DOMICILE
To the Clerk of the Circuit Court [County Comptroller) ST. l~UCIE County. Florida.
T~is is my declaration of domicile in the State of LO (Q , that I am filing
Lhis day in ac.:ordance and in confoi-mity wiEh secrio.± ___,. r,.~->uy ~',;~u;~s.
: -
FOR DOMICILIARI£S OF THE STATE OF FLORIDA:
I hereby declare that I reside in and maintain a place of abode at ~'~ 3 ,'1 C A~JF m~ ~-~^;'
street an~c nu e
~~12~'~ ~.. ~--UC~ , zn ST. LUC 1 E County, Florida, which place of abode I
c 1 t y .,.r;, ,~ r_-
recognize and intend to maintain as my pez~r-anent home and, if I maintain another place or
plac:es 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 predominant and principal home,
and I intend to continue it permanently as such. I am, at the time o making this declara-
r ion, a bona fide resident of the State of Florida residinq at`-?33 ~cA~m.~ (_,IJ, .
~street a num er
lo~ ~r, . u~~ f . in S~' ~. ~- c~~ County, Florida. I formerly resided at
c i ty -~",;~ = ..~'h
~A 1'O n 1'o u . ~p n rno~tT f-~ ~our.ty, ~iJ rE.~S £ , and the
city state
place or places where I maintain another or other place or places of abode re as follows;
(Here list street address, city, county and state of any other place or places of abode.)
~ECAME A RESIDENT ON THE ~ S DAY OF ~E ~~liR ~ 1~~ ~
~~ouNry ~
~ j ~ .- ~~t:f,: - ~..~ co ~ ~-i~cj.Q ~ ~ °~,o-~~~
~: f ~~ :~, ~
•v~= ~ ~' `~' signature
'._ -- ~ -' oQ
' ~A\
~ ' ' ~
~V~~.~ • '`
~worn to and-subscribed before me this Q~ day of ~~ , A. D. 19 g~ .
ROGER FO I TR~ S, CL ERK C I RCU I T COU2 T
5T. LtfC I E COUNTY, FLOR i DA
~:~:tary Public State of Florida at Larae. ^ ,
My Commission expires '. BY~ ~~~uU~ OEPUTY CLERK
"r"~P. DOMICILIARIES OF STATES OTHER T}iAN THE STATE OF FLORIDA:
c ~,a.s cz ~-.~,~~~-~c+w~r~:~sc;~~cxa~..^:,,r,~a.-~.-rss - ---
~:,ezeby ceclare that my domicile is in the State of and that I intend
cc :ermanently continue and maintain my domicile in suc~ state. At the tine of ~:aking this
:~claration I am a bona fide resident of the State of My place of
~-:~o3e within the State of Florida, if any, is as follows: Here ist street address, city,
~^d county of p2ace of abode in Florida.) ~
;:=erson making declaration ray also include such other and further facts with reference to
:~:y acts done or performed by such person which such person dssires or intends not to be
~~r.strued as evidencing any intention to establish his domicile within the State of Florida.)
5195-~30
~K~-s~r4i
f~lf0 ~M€ FCCC~PREO
ST.IUCtE OUNi Y.I l A.
ROGER POI1Rp5
CLERK CIRCUIT C4UR ~
- i:E~^ ~ = N'. . . ~ ~ - - -
/
=~~orn to and subscribed before me this
':otary Pub ic State of Florida at Large.
"r`.y Commission expires
signature
day of , A. D. 19
3J0 (~ PA6F ~~
,
,
_ . _.
. _
- ~ - -- ~-- - ._ . . ...
.~~ _:. _, _
, _ :_ _ ~
~_F_ , .. _ .. . _ _ -_