HomeMy WebLinkAbout2002 ~pet:illrAl~c~n ua Lvuui~ur
STATE OF FLOR I DA i0 212 0 5 ~
~ • COUNTY OF' ST. LUCIE . ' '
This is my Oeclaration Docnicile in the Stete of Floride that I am filing thi
day in accorda~ce end in.confoi~mity vfth SECTION 222.17; Florida Statutes.
I ~ (We~ ~ ~j `(~f~-t~ f~~ .
• p ease pr nt your neme c ear y
became ~ a bona f ida resident of the State ~of ~jlorida on I 2- 19 8`
~ 1~ , 1~ ~-~2~-.~ ~ A f
t'~~~ "
•and I reside et ~
in the Ci ty of E>RT ~'T"- v c-~
~ ~~1- 9~~
My mailing address is: P•~ x 3. C_ J~
f eren rom s reet a ress
My former legal residencs vas in the City of W~~--m C~''U'`'
State of ~-~w ~L •
. .
(No further statetaent is required. Hovever, if you wish, you may insert any
perti~ent facts such.as sale of pxoperty or business o'r relinquishment of
employment at foraner domicile, removal of family to new domicile, purchase of
home, 'etc. ) . •
I FURTHER CERTIFY I vill comply with all requirements of a legel resident of
this State. I understand there fs a penalty £or perjury;perjury is a Felony
~ and~is punishable by incaration in the State Department of Corrections.
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E PRINT NAME SIGNATURE
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~ PRINT NAME • SIGNATURE .
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~ Sworn to a subscri~ed before me this day of ~ , I9 ~0
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s S I} ' CIRCUIT COURT
i , ~ y / ~ 7 ~
~ ~ Depu y C er
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~ RECORDING INFORMATION
~otary Pui~lic, state of 1021205
yy Cor~mission expires: • ~ ~90 ,1AN 2,4 P3:36
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. FiLtQ ANG R~Crri~.~
~ seal) ~ SOU~UC~ O~G ~N1 Y.
~ GG UUUGLAS DIXON '
~ , J'y R~c Fee 5 _ .
~ , ~'"~4`"~~' St. Lucie County
~ TM~ COG Add Fee S
~ -~.i ¢ V Clerk of Circuit Co j,.
, - Uoc Tax S
~ , t ;^.t Tax S aY
~ +r,,'~ ~ ~ ~ L • . 'Deputy Cierk
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L~~~ Cou+m 1 t
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~o~~s7~ P~~Ezaoz
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