HomeMy WebLinkAbout0959 . ~ ~ ~ . ~rt{~rnii~n aE ~mlticil~
: STATE OF FLORIOA 8398Q9 `
; • COUNTY 8F ST. LUCIE . ~ •
This ~s my Dec2aratf.or pomic~le in the SCate of Flor~tla tha~ I am t~lins th3
day i~ accordance and in..confo~mixy with SECTION 222.17; Flor d~ Statutes.
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Y, We~, C~.~'S . y~- ~vUIS,~ d~8 ~4 L-.K~
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p ease pr nt• your n~me a ear y
.became~e bona f~de residert oF Lhe StatF~o~ Flor~.da on ig
~.~..`~r~ w.ww~...w.~ w
•and I reside at ~~~-~3~ ~
in the City of • G,~" F'.~
My maxling address is: ~
f eren xom "street a ress .
My f ormer legal residence was in the Cf ty of
Stat~ of ~ .
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(No further sLatement.is required. t~owever, if you wish, you may i~sert a~y
pertinent facts such,as sale oE property or,business or relinquishment of
; employment ati former domicil.e, rem~val of Family to new domfci~e, purchase of
home, etc.) ~ . . ,
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I FURTHER CERTIF'~t I will comply with all requfrements of a legal resfdetjt o~
this State. I understand there~is a penalty for per~ury;perjury ~s a Felony
~ ~and'is punishable by incaration in tho State Departmenz_of C~orrec~ns.
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~ C'~'~sT~'.~ J ~ /~a,~l ~ ~i~~ - r' ~ ~
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PRINT NAME SI~IAi'I`U
L_...1~UIS~' ~~t3/~~-~,~' ~~~~1~~
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~ PRINT NAME SIGNATURE .
Sworn to.and subscrified befora me this day of ~ , 19
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?x~t~bAS 0~1; ' RK CIRCUIT COURT
BY ~
` e ~r _
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~ ~ ~ RECORDING INFORMATION
~ Aotary Pubric~;';~'tate of • ~ .
My Co~,miss~on expiresz__.___,~~~! ~ , 8398~~
. 't '87 AUG °4 P12 :Ol _
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(seal) . . Fl~i . t;r~,
# DOUG _ ~ f . .
} . ST. lU~
~ - • BOC~( 5~~ P,iGE 9~
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