HomeMy WebLinkAbout0980 STATE OF FLOAI~/~ ~ ~
'7416~1 ~
OOUNTY OF ST . LUCIE
Thia 4s my Decla~Uon of Domldie in the State of Floride that I$m filing th~a day in accordance
and (n coMO~+ih? wlth SeCtion 222.1 T~ Flori~l8tatutes. •
~ ~We~ ,T~At~k ,~~r~ L~
~ lRill3t INNT Yo1N~ MAM! CIiAKY)
became e bona flds ~d~nt of ths 3tate of Florida o~.~?~. ~3 ~ _
and I res~de st , d,~Q
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l~t
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S L A~1p
M the City of__~._~~e / iP pr P ~ I
My mailing address ts: 1~~ ~A,~L w~~ ~ a ~'t' Pt~ ec~ ~
af o~s~r ~ an~Er ~ooRasa
N1y former IeQal residence waa In the Cfty of _ Ce ~ u w, b s
stace oi a ~1 n , .
(No further atatement ta roquired. However. it you wish, you may insert eny perttnent facts
such as sale oi property or bust~ess or relinquis~hment ot empioyment at former domiclle~ remo~val
oi tamily to nsw domicite~ purchass ot home. etG)
~~,Q•LC ~ S~?-r _ /~i( n n~ 01e
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! FURTHER CERTIFY 1 witi compty with al~ requirements of e legal reside»t ot this State 1
understand thers ts a pet~atty for perjury; perJury ta a Feto~y and is punisf?eble by ir~caration in the
State Departmont of Comections.
FA~ K ~E~f~NGEQ ~ .
PRINT NAME SIGNATURE
PAINT NAME SIGNATiTRE
7HIS SPACE FOR RECORDING INfORMATION
.
sworn co ana subscribad beton n+~ tt~a ..~.'dsy ~ 3 A~ 1~22
. of 19'~ ~'~o F?~` _
ROGE~;
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~ ;Z $j zu~ -
ItOGER Pt~,~'~i;AS ~ CLERK CIRCL'IT CT. -
: By ~ ~ ~ _
~ - ~ ~41641
Deputy Clerk
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r~a,~ T o'. i3 ~ d~ca~ K L9,~~
Notary Public ~ State o.f. ~l. ~ .
My Comattission expires . . . . . . . . . . . . ~p~ ~
FORM 20 (if y
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a..." ` s,~°„`.'~»R. `s°~w. ( s e a 1)
e~~x 488 PA~E yso
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