HomeMy WebLinkAbout0967 . " ~ . ~tcl~sr~tian af ~a~ir~te
STATE OF FLOR IOA ~~O~O~
COUNTY OF ST. LUCIE '
1'hi~ ~s my Declarat~or Oomici~~ ia the Sta~e oi~ F~o~~t~a hat I am filing thi
day in eccordancs and in.con.Eoirmi~y wlth SECrION ~2 F~oride Stetutes.
I ~ ~ ~e ~ ~ --~-~l~jqr?.~ a ~ ~ ./~'1 .~F'i i"~.~ _ . , _
""'"Z"p ease pr~ri~
youx nacns c ear y~' •
.bacame'a bona lids r~sidert o! the State~oE Florida on 6/~19~
•and I reside at _,,,1~~ Y s• E:._,~!tJ,S~~',L,__L~?,=,~..~.,. _ ~
~ irt the City of P'~--, ~r~ L v c. `
~w~w~~ ~r~wsw~~r ~ ~~i~.~rar~ ~ r ~~~~~r ~ ~ r~.~...
My mail~ng address is: ~
eren rom s ree a resa
My former legal residence was in the City o~ C~i~J~-vti~
S t e t e o f 1~,_
I,/~~, • ~
(No further staLemenl~ is required. However, if you wish, you may insert a~y
pertinent facts such.as sele of property or business or relinquishment of
employment at former domicile, removal of family to neW domicile, purch~se of
home, etc.) ~ - ~
. ~
I FURTHER CEItTIFY I will comply With all requirements of a Iegal resident or
this State. I understand there is a penelty for perjury;perjury is a Felony
and'is punisheble by incaratior in the State Department of C~orrections.
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~}/2~'rIt'~II~4 ~ • /~'7i~/E'i,?t-o C .
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PRINT NAME ~ SIGNATURE
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PRINT NAME SYGNATURE .
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Sworn to end subscri ` sy. this day of , 19
DOUG IXO , COURT
By . ~t c
epu : -
y~~
~J•~rWr .
~ Sl~~~ RECORDING INFORMATION i
~ yotary Public, State caf 834503
Hy Cocrynissfon expires s • •
~ • . ~ ~ •gl ,1l~116 P 1:11
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't)RqED
FIIE"t~ ~
~seal) ~ OOt1Gl~~,ClAllN CLERK
St. ~.UC1~ COUNTY. fL.
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~5~1~ ~E 9~7
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