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':o the Clerk of the Circuit Court (County Comptroller) ST. L UCIE County, Florida.
~:'~:is is my declaration of domicile in the State of ~L / , that I am filing
t'~is day in accordance and in conformity with Sectio , F ori a tatutes.
fieR DOMICYLIARiES OF THE STATE OF FLORIDA:
: hereby declare that I reside in and maintain a place of abode at ~Tf~.(JL~ ~',~%CJ~' ,
street an n er
~~j, /F'~~ cc , in ST. LUC I E County, Florida, which place of nbode 1
city
:ecognize and intend~to maintain as my permanent home and, if I maintain another place or
olaces of abode in some other state or states, 2 hereby cleclare 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 this de ra-
t ion, a bona f ide resident of the State of Florida residing at L~~~iv~-
n/~,~~f, street an n r ~
/i , in ,~'~l.~~'/~ County, Florida. I formerly resided at
c~ty
, t~ (_I~~~ ~ County, /LJ , and the
~~~"-~~ity state
place or places_where I maintain another or other place or places of abode are as follows:
tHere list street address, city, county and state of any other place or places of abode.)
1 BECAME ~ RESIDENT ON THE ~ DAY OF IIJ/~ ~ ~ 19~. ~
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Sworn to and subscribed before me this ~ day of , A. D. 19~.
" ~ ROGER I TR~ S, CL ERK C I RGU I T COUR T
I, S UC 1 E COUNTY, F OR I DA
~~:o=ary Public State of Florida at Large._ ~
~!~;l Commission e~cpires BY DE P U T Y C ~ E R K
FOR DOPIICILIARIES OF STATES OTHER THAN THE STATE OF
.ereby declare t at my domicile is in the State of and that I intend
' to permanently continue and maintain my domicile in suc state. At the time of making this
` ceclaration I am a bona f ide resident of the State~of My place of
abode within the State of Florida, if any, is as follows:. Here ist street address, city,
a^d county of place of abode in Florida.)
~'person ~naking declaration may also include such other and further facts with reference to
= an~~ acts done or performed by such person which such person desires or intends not to be
~ cor.strued as evidencing any intention to establish his damicile within the State of Florida.) .
~ ~ 526'752 '
~ 1981 ;~z.`i -4 Al~ i1~ 3 {
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~Sw~rn to and subscribed before me this day of , A. D. 19 I`
':otary Pu ~c State o Flori a at Large.
~`y Commission expires
_ ao~K354 pacE 96~
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