HomeMy WebLinkAbout0986 . ~~r~t~~n ~ii Zvoaiu~~t
~STATE OF FLORxDA S44'428
• COUNTY OF ST. LUCIE '
This !~s my Dec~aratior pomi.cile in the SLate oF Florida that I am f~ling thi
day in accordence and i.n.confoi~mixy aith SECTIQN 222.l7; Florida StaCutes.
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p ease r rt•your name c ear y
. became ~ a bona f i.de resident oF the St te of Flori.da on ~ ~9,~
.
- •and I reside at
~ in the City of `
My mailing address is:
f eren rom s ree a ress
My f ormer legal residence was in the C3 ty of_ /~~!¢~.~n ,~~,o - ~
State of •
(No further statement ~.s required. However, if you wish, you may insert ~~y
pertinent facts such.es sele of property or business or relinquishment of
employment at former domicile, removal of family to new domicile, purchase of
home, etc.) •
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I FURTHER CERTIFY I will compl.y with all requirements of a legal resident or
' this State. ~I understand there is a enalt for er ur • er'ur is a Felon
~ P Y P~ Y~P J Y Y
~ and~is punishable by incaratio~ in the State Departmen~ of Corrections.
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PRINT NAME SIGNA URE
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PRINT NAME SYGNATURE
Sworn to and subscrib 8~d~fRj, this o~~~~ day of ~ 19
GLAS DI~ON COURT
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Deputy
•'•'-~~•c•, ~ ~ ~ ' - .
~f ` t~'~ . R~COR~ING INFORMATION
?lotary Public, State of 844428
yy Commission expfres: •
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` ~ ~ ~ '87 AUG 27 P 1 :58
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