HomeMy WebLinkAbout0941 v ~ ~i
STATE OF' FLORIDA $Z'~~01.
COUNTY OF ST. LUCIE ' ,
~
This is my Declaration Qom~cile in the St~te of Florida that I am filing thi
day in accordance and in.conformity with,SCG'TION 222.17, Florida Sttatutes.
I, (We), L U. ~ h Y~es ~.u ~l
p ease pr nt your ~ame c ear y
. became ~a bona fide resident of the State of Florida on y- Z.y' 19 ~
•and I reside at .90 ~ ~ 7 Z~
~ in the City of yt e
My mailing address is: -s ~lj»C
i dif eren rom s reet a dress
My former le$~1 residence was in the City of Oy~ t;'~
State of ~ 1Q~ •
(No further statement is requirec~. However, if you wish, you may insert any
pertinent facts such.as sale of prqperty or business or rel.inquishment of
employment at former domicile, removal of Eamily to new domicile, purchase of
home, etc.) ~ •
'
I FURTHER CERTIFY Y will comply with all requirements of a legal resident o
this State. I understand there is a penalty for perjury;perjury is a Felony
. and~fs punishable by incaration in the State Department of Corrections. "
_ u. c. C1~ Q Y 1es L.~ l/~t . `
- . .
PRINT NAME SIGNATUR~
PRINT NAME SIGNATURC
Sworn to and subscribed before me fihis ~_day of , 19~
" D~TGLA~ D~ XON, CLERK CIRC OURT ? .
_ By ~ C!/CL~'~ ~p~Nly
Deputy Clerk J~ f` ~'~.~'o t
;
V: sG .
~ .
} RECORDING INFORMATION
F 1 ~f ~y •
~ ~totary Public, State of ~~'•~a~ ~~~f 82'7401 ;
` ~1y Commission expires: 'fcour+jY•
. • . '87 ~ Jt~l -1 P 1 :21 ~
` ~ ~ _ ~ :
~ FILED aND K~cOROEo
f ~ (seal) OOUGLAS OIXON CLERK
f ST. l~1CiE COUNTY. fL. ~
~
f` ~
;
i '
,
i
t
i
, . . . °aooK 5~~ PAGE 9~
- - -
-3~r+.--r ~ - . , .
t ± . y-7.-_.._3-I[=~~~- .