HomeMy WebLinkAbout1571 ~Hec~~rbt~~n ui ~umu,~e
~ ~azoses ~
STATE OF FLORIDA ~
~ • COUNTY OF ST. LUCIE . ' ~
This is my Declaration Domicile in the State of Florida that I am filing thi
day in accordance and in.conformity vith SECTION 222.17; Florida Statutes.
I, (We), i ro E ( OS
p ease pr nt~yout name c ear y
became ~ a bona f ide resident of the SLete of Florida on f~ P,e~ ~ 19~~
~and I reside at ~ O ~ ~ W C ~M ~v . ~ ~
in the Ci ty of ~ o~Z ~ 7 ~ v C i~ L?~1 3~ 5 S~
My mailing address is: .
f eren rom s reet a ress
My former lega residence vas in the City of {V ~°c,e> Cc T-
State of l° W •
,
(No further statement is required. However, if you wish, you may irisert a~y
pertinent facts such.as sale of property or business o'r re~inquishment of
employment at former doanicfle, removel of family to new domicile, purchase oE
home, 'etc. } . •
I FURTHER CERTIFY I will comply with all requirements of a legal resident of
this State. I understand there is a penalty for perjury;per3ury is a Felony
and~is punishable by incaration in the State~Department of Correction
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~ PRINT NAME ~ IVATURE
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Sworn to d subscrif~ed before me thie _,~~'"_day of , 19~
~ RK CIRCUIT COURT
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' Deputy C er
• RECORDING IPIFORMATION
~ ?lotary Public, State of 102098g
yy Co~cnission expiress • ~ .'y0 JA~a 24 A10:5y
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; ( s e~t~~~. ~ ~ ; ~ : . : • " •
. ~ ^~r°'• Rcc Fee S _ l):)UtiLAS UI~U~1 •
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~ r . . . - - ~ :\dd Fre S St. l.ucie Co~nty
~ _ ~ " ~ Dc~c Tax S Clerk o( Circuit Cuu ,
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g ~ ~ . ~ : p ~l~
~ ' . s.r. -:•_i..f• ~ ~Ill 137C .S - p~7 ~
' ' D ~ Qcruty C{erk
t~l:w~'
~ Total S
. . so~ 674 ~f 15?1
~ y~v ~;~g
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