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DECLARATION OF DOMICILE
To irie Clerk af the Circuit Court (County Co~:ptroller~
This i5 my
iiii~ uny ii•
ST . L lJC I E
County, Florida.
declaration of domicile in the State of f-'~j~~~ , t~at I
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F'OR DOMICILIARIES OF THE STATE OF FLORIDA:
am filing
I hereby declare that I reside in and maintaih a place of abode at '~ 2~ J.. ~. ~~II n
• street an nu er
~"~" ~ S~- ~.~-~ ~- , in ST. L UC ~ E County, Florida, which place of abode I
city
recognize and intend to maintain as my permanent home and, if I maintain another place or
places 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 of makin t is decl ra-
tion, a bona fide resident of the State of Florida residing at Z~j ~~ ~t.~1.,~1~
~ ~ - ~ street an~n r
1"l.`~ ~~r L~~ ~ , in ~ ~ ~ ~-~~-I ~ County, Florida. I fbrmeily resided at
city
~ " ~ Count +k- and the
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city ~- ~ state
place or places where I maintain another or other place or places of abode are as follows:
(Here list street address, city, county and state of any other place or places of abode.)
BECAME A RES 1 DENT ON THE ~~~+ DAY OF 1~~ ~ l~ I~ ~
'U iC1~ N. - c~~~_i'~
~~r lc3rC C' iG Z._- c'~ ~~' 1 I
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Sworn to and subscribed before me this ~
::otary Public State of Florida at Large.
My Commission expires .
BY
FOR DOMICILIARIES OF STATES OTHER THAN THE STATE OF FLC~RID?~
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YY CLERK
7-Fiereby declare that my domicile is f~ the State of and that I intend
to permanently continue and maintain my domicile in suc state. At the time of making this
declaration I am a bona fide resident of the State of My place of
abode within the State of Florida, if any, is as follows: Here ist street address, city,
and county of place of abode in F2orida.)
!Person making deClaration ma}~ also include such other and further facts with reference to
any acts done or performed by such person which such person desires or intends not to be
construed as evidencing any intention to establish his domicile within the State of Florida.)
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ROGER POI TRAS, C~: C tRG~'
ST Ll1C I E COUNTY: ~~ ~DR I[3A
signature
S«orn to and subscribed before me this day of
':otary Pub ic State of Florida at Large.
`".y Commission expires .
A. D. 19
~~`~x351 ~~~t 562