HomeMy WebLinkAbout06015162'78 . ~
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DECI.AR~-TION OF DOMICILE
To the Clerk of the Circuit Court [County Comptroller~ ST. LUC I E County, Florida.
This is ay declaration of domicile in the State of , that I am filing
this day in accordance and in confonaity with Section ~'F'F.13', F olii~cla $tatutes.
F~It DO!lICIL2l1RIES O~ THS STATB OF FLORIDA:
I hereb~ declare that I reside in and maintain a place of abode at ~, kc 73~- .
~ , , s ree _ anci numper ~
~ , in ST. Ll1C I E County, Florida, whicb place of abode I
c y
recoqnize and intend to maintain as my permanenL h~ae 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 haae,
and I intead to continue it permanently as such. I am, at the time f aking this eclara-
tion, a bona fide resident of the State of Florida residinq at 3 2,
,: i ~ , stree an number~
,t~- ,Lc.: , in ~_ ;~G~~ County, Florida. I formerly resided at
7~ , . c ty a~
•/ , K2~ County, q~~~ , and the
city) state' ~
place or places where I maintain another or other place or places of abode are as tollows:
(~ere list street address, city, county and state of any other place or places of abode.)
~~our~Ty
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5worn to and subscribed before me thf s ~ day of ~~-~~`2'^Qn.~i , l~. D. 19 O~.
ROGER PO I TRA S, Gl ERK C I RCU I T GOI~t T
ST. LUGIE OUNTY, FLORIDA
Notary Public State o~ FYorida at Larqe.
ray Coenmission expires . B Y~ /I~ DE P u T tr C l E R K
FOR DOMICILIARIES OF STATES OTHSR TH]~N TAE STATE OF FLORIOA:
er ec are t ay omic e is the State of and that I intend
to pez~manently continue and aaintain ay daaicile in such state. At the time of making this
declaration I a~ a bona fide resident of the State of My place of
abode vithin the State of Florida, if any, is as follors: CHere list street address, city,
and county of place of abode in Florida.)
(Person aakinq declaration may also include snch other. and further facts with reference to
any acts done or performed by such person vhich such person desires or inter,ds not to be
construed as evidencing any intention to establish hfs daaicile vithin the State of Florida.) ,
5162'78 .
1981 FcU -9 ~.~ ~~ 49
f t::C :Ni ". Cur.:.t i
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Fi(~G~R PCTjft~15_
CLE~K ClR..L. ~ C. -
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(siqnature)
Sworn to and subscribed before me this day of , 1h. D. 19 .
Notary ~bu ~ic State o F~a at Larqe.
!-!y Coaanission expires .
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