HomeMy WebLinkAbout0999 . ? . ~tcl~r~ii~n r~ ~oaticitt 862`7s4
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STATE OF FLOR~DA .
COUNTY OF ST. LUCIE •
This ~s my Decleratio~ Domicile in the State a!` FloriBa ~he~ I em filing thi~ `
day in accordance and in.cott~c+i~miLy vith SECTION 222.17; F or da Statutes.
I,(We), ~~t ~
. p easa pr ~•your nams c ear y
. became'a bana f~d• resident of the SLate of Florida o~ tt ~i'g
g~
•and I reside et o'i~ FI~2I~
in ths City of " ~ A ~
My mailirg addresa is: ~ ~
. eren rom s ree a ress
My f ormer legal residence aas i.n the Cf ty of Jr1Er~1 C/o~ (j32o_x~
State of
_ E.tal.~~t4ti.~..._.
:
~No further staLemenC is tcequired. t~orrever, i~ you wish, you may i~s~rt any
pertinenL facts such.as sala of prope~ty or bus~.ness or reli~quishmen~ of
employment at fox~mer doaaicile, removal of Eamil.y to new domicile, purchase of
home, etc.~ ~ ~ .
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I FURTHER~CERTIFY I vill coaply vith all requ~,rements of a jegel resident o~
this St~te. I understand there is a penalty for per3ury;perjury is a Felony
s~d~is punishabZe_by inceretion f.n the State Departaaent of Corrections.
~.~Na a i= ~r,~i'T'_.N ~/1~~ ~rv, , ~
PRINT NAMB ~ SIG~NATURE -
PRINT NAME SIGNATUItE .
Sworn to and subscrff~ed before me this ~ ~ y' ~
~,~day of ~ , 19 .
UGLqS D~gQ~t ~ RbC CIitCUIT CAUItT -
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RECORDING INFORMATION
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~lotaxy Puh~fc, State ~ t ~ • ~
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f ~y Co,m,mi.ssion expiress-`~:'~'"~ • ' • .
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