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t;ORRBCTIVE DQIICII.E - corrscting tM dat~ of r~aidsncy o~ uo.~icti•
rscorded i~ 0lticial Rscord Book 3S0 pa~s 1036, public r~corda o!
St. Lucis, ~ ounty~ F1.
5~~3
DECLARATION OF DOMICILE
~o the Clerk of the Circuit Court (County Comptroller~
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signature~' ' f. ~i,. ~ ~
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day of ~~1(/i~ . ~'.,~~•,F~ ~/tQ j.. •,~~. N ~
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ROGER P01 TRAS ~ I~ _;r IRGI~(~~L~'OURT
ST. LUC i E COUN,~'~ I OA ;;~? _~
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BY ~ .~^ ~(~~`~Pt~T~Y CLERK
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County, Florida.
~.his is my declaration of domicile in the State of ~ L Oi2 ~ v~ , that I am filing
c~~is day in accordance and in conformity with Section ~~~TT, Florida Statutes.
rOR DOMICILIARIES OF THE STATE OF FLORIDA:
1 hereby declare that I reside in and maintain a place of abode at ~`~ 1 o S ~.4 Qo S ,
street an nu er
t`~ ~ ~r ~-`~cel I= , in ST. l_UC 1 E County, Florida, which place of abode I
city ...r~,,<<.•
--~cognize an@ intend to maintain as my permanent home and, if I maintain another place or
:~laces of ab~de in some other state or states, I hereby declare that my above-described
:~sidence and abode in the State of Florida constitutes my predominant and principal home,
~~d I intend to continue it pernsanently as such. I am, at the time of ;naking this declara-
r~on, a bona fide resident of the State of Florida residinq at ~G LoS L-.~4G-oS .
/~ C~ street an nu~r~-
___ l b.1-~ ST- l-~ ~-lF , in /i'- ~t,c C~ : County, Florida. I formerly resided at
city C T'~
N~,,,.~ `-to~~-_t~ ~t'`( . fJ.:_.~ ~v~'L-f•` County, 1,~(= ~~~/L _, and the
-~city) state
:%lace or places where I maintain another or other place or places of abode are as follows:
(t:~re list street address, city, county and state of any other place or places of abode.)
RT1l
~ECAME A RESIDE~~T ON THE V DAY OF ~-~aJr~-L„~.~,19_~Q .
:'worn to and subscribed before me this /~p
=.=ary Public State of Florida at Large.
~'l Commission expires __ _ _ .
rµ~R DOMICILIARIES OF STATES OTHER THAN THE STATE OF FbA~$A: //
- ~ nf :rs~v:.~a+~+ea._s~s~ -~t-~~~...-a~e~g_ V
_::ereby declare t at my domicile is in the State of and that I intend
-o permanently continue and m3intain my domicile in suc state. At the time of making this
'.~=ciaration I am a bona fide resident of the State of My place of
=-c~~e within the State of Florida, if any, is as follows: Here ist street address, city,
:-,d county of place of abode in Florida.)
'=erson making declaration may also include such other and further facts with reference to ~
~
:::~ acts done or perforr.-ed by such person which such person desires or intends not to be ~
_~-:strued as evidencing any intention to establish his domicile within the State of Flor:da.) ;
~/i-~l~t~ ~
~~ ~~ ~ 6 ~ ~~ ~ ~
=.:~rn to and subscribed before me this
:~*_ary Pub ic State of Florida at Large.
";~ Commission expires .
ST. Ll1CIE
i11~0 4MC `[CGPDf :•
St~~} R POITRAS~
fi1r~$~~CtRtU:? CQti~j ~
RE E~R~'~ 1'4 ~?'r : 's ~-
signature "
day of , A. D. 19
~~350 P~1989
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