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516119
DECLAF.i,"_'.' ~.`: C F D~v I:. Z'.E
To the Clerk oF. the Ci.rcuit Court ICounty Ca~nptrol~er~ ST. LUC I E County, Florida.
:his is my declaration o~ domicile in the State o_' , that I am filinc
this day in accordance and in conformity ~ith Section 1~~T7, Flarica ~tatutes.
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FOR D8l3ICILURIES OF THE STATE OF FLORZDA: ~
z hereby declare that I reside in and maintain a place of abode at ~ ,,,~.~ ~'~ --_2-r j
stree~ an~c nu.:.aer-T'- ,
~~'t-n~c~NJ ~~ , in $T~~IX: I~ Co•.uit~•, Flori.da, which place of abode I ~
-Zci y.
recocnize and intend to a~aintain as my permar.ent home and, ~f I rr.aintain another place or
~laces of abode in..sflme other state or sLates, I hereby 3eclare that my above-cescribed ~
resideACe and abode in the State of Florida constitutes my predominant and principal haae,
and I intend to continue it permanent~y as such. I am, at the time of makin this cec2ara-
tion, a bona fide sesident of the Sta'te of Florida residinq at ~ ~ Z ,
(street an m.u*~ner)
~ ILSF~iV ~,hf , in ~_i( uC~ County, Florida. I formerly resided at
c ty ~
.fTC , ~~ County, ,p~. , and the i
c ty 'rstate ) ~
place or places where I maintain another or otner p2ace or places of a~odr are as follows:
(Here list street address, city, county an~ state of ar-y other place or places of abode.)
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sworn to and subscribed before me this ~ day of ~ , A. D. ~ Y9~:''~~~~ '
~ ROGER P01 ~RAS, CLERK C IRCUI T COt~2T
ST. LUG I E COUNTY, FLOR t OI-
t
r:otary Pub~ic State oi F~qrida at Large.
My Commission expirea . B Y~''` ~~~ DE P U T Y G l E R K~
t/ ` s
FOR DOMICILZARIES OF STATES O'1'~R TH11N T~ STl-TE OF FIARIO~: `
;
~ er ec are t my omic e is the State of and that I intend
~o permanently continue and mafntain my doznicile in such state. At the time of makinq this
-'~claration I am a bona fide resident of the State of My place of •
abode within the State of Florida, if any, is as follows: ~~iere list street address, city, .
and county of place of abode in Florida.) ~ .
;~erson making declaration may also include such other and further facts with reference to i
ar.y acts done or performed by such person which such person desizes or intends not to be t
~onstrued as evidencinq any intention to establish his do:aicile within the State of F:crida.) ~;
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19~81 f f B-6 AN I~ I I
ilt£0 Rhf F~COPDfO
51_llJC1E COGN;Y.~LA.
RCGER P~ITRAS
• CLCY.K ClkClil ~^;!!?t rD
F ~ f ( : ^ . . • ' `j!Q!
(~
T /
r.-
(siqnatuze)
sworn to ~aad subsczibed before me tlif s
t~otary puD11c State ot Florida at Lazge.
My Commission expires .
day of '
, A. D. 19 .
.
, ~~348 PAGE 353 . ~ '
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