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DECLARATION OF DOMYCILE
~/
~o the Clerk of the Circuit Court (County Comptroller) ST. l.UC1E County, Florida.
;~is is my declaration of domicile in the State of ~ L ~ , that I am filing
this day in accordance and in conformity with Section`~~ ., F ori a Statutes.
r'~%R DOMICILIARIES 4F THE STATE OF FLORIDA:
I hereby declare that I reside in and maintain a place of abode at R o A d R u N'!~' E'R .
^ street an nu er
-T,%~ q~ ~i4 OR/ ~~c~ in ST. LUC 1 E County, Florida, which place of ~bode I
__ city -J.,.=f,~ ~
rt~cognize and intend to maintain as my permanent home and, if I maintain another place or
~Iaces of a~ode in some other state or states, I hereby declare that my above-described
~i~sidence and abode in the State of Florida constitutes my predominant and principal home,
?~d I intend to continue it permanent2y as such. I am, at the time of making this declara-
~ ion, a bona fide resident of the State of Florida residinq at ~o~c ~~~,Q V~Lv~
, street an num~rT-
f'c,ft %~f ~~ C , in -~ ~. cr 2. -~ County, Florida, I formerly resided at
- ~---~
~~~ city . G~i S~pi/.S'~ ~ ~~ C un Y. ~~t Sec~d~~~ . and the
city ~ ~state ~
-1ac~ 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 RESlOENT ON THE ~v OAY 0~_! ~ 19 ~~ .
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'~orn to and subscribed before me this ~ day of ~/N , A.~ D:y~~j~y~~:
. ROGER POI TRQS, CL RK C IRCUi T COURT =,
ST LUC I E COUNTY, FLOR I DA =
~
': :~ry Public State of Florida at Large.
~': Commission expires B c DE PUT Y C L E R K :
~
=.,R DOMICZLZARIES.OF SfiATES OTHFR THAN THE STATE OF -
~_-_ aC~:-.v<x^L;-lRL~:f:ZtCy+~'3~k
;:,ereby declare that my domicile is in the State of and that I intend
~~ ~prmanently continue and maintain my domicile in such state. At the time of making this
--c'_aration I am a bona fide resident of the Sta*_e of My place of
=~~~3e within the State of Florida, if any, is as follows: Here ist street address, city,
=_~d county of place of abode in Florida.)
_ ~
~rson rr~aking declaratipn may also include such ot2:er and further facts with reference to
..-~; acts done or performed by such person which such person desires or intends not to be
~~~-.strued as evidencing.any in~ention to establish his domicile within the State of Florida.)
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51~39
q81 NAR 10 I~t i~ 17
fti~EO aN[ ~ cokt-fa
Si.LUC E CpUN~Y.ft A
FidG~R POI~RAS
CLERK CIRCUI COURi
cr(;I1Pr: Y~ F!F f: '' ~~~'-~---
signature
-•.,orn to and subscribed before me this day of
':~tarv Pu ic State of Florida at Large.
'•'1 Commission expires .
, A. D. 19
a{~~K350 PA~E 542