HomeMy WebLinkAbout2003 . ~ecln~t~ti~n af ~omicil~
STATE 0 F FLOR I DA 10 212 0 6
COUNTY OF ST. LUCIE '
This is my Declaratior potaicile in the State of Florida_thet I am Eiling thi
day in accordance and ir.confoi~caity vith SECTION 222.17; Florfda Statutes.
I, ~f~'l/GG ~ ~~V .
p eese pr nt~ your n ~
became ~ a bona f ide resident of Lhe State of Florida on -~~~t-~g~
~and I reside at ~ S E- ~p~~^i'~ S~ F ~
in the CiLy of oi2i" s'% G~cr~ ~-Lo~C.,~ .-s~ .~2
My mai2ing address is:
f eren rom s ree e re~s
My former le al residence was in the City of L-
State of M~"~~'~~'' ~
. -
tNo further statement is required. However, if you wish, you may insert any
pertinent facts such_as sale of property or business oc relinquishment of
employment aL fo~cmer domicile, recnoval of famf Ly to new domicile, purchase of
home, 'etc. ) , .
I FURTHEIt CERTIFY I~ill comply with alI requirements of a legal resident of
this State. I understand there is a penalty for per~ury;perjury Felony
and~is punishable by incaration in the State Department of C~arr ctfo~ .
.~~,~y ~~,A,,,, ,/.9~v _
_
PRINT NAME ~ SIGNATURE
PRINT NAME • SIGNATUKE .
Sworn to an subscrf~ed before me this __~~%~._.day of , 19~__~[
D ' , IRCUIT COUAT
"Z ,
Deputy er
_ RECORDING INFORMATION
uotary Public, State of ld21~06
~ty Cor~mission expires: ~ ~ . w90 JAN 24 P3:36
. 6h
Ft~ce ar~~ ~~C~h.:.
nouc~AS a~xoN ,
~'Qa'~~. `t~, Rec Fee S "~v i3vUGLAS UIXON S~• CUt;l~ C~JNT Y. ~
_ ~ if~ Add Fce.S ~ St. Lucie County .
, Unc Tax S_ Clerk of Circuy"'LJ Co t
, ~ ' ~~7j/.J ~
~ `4-f,1~C~ '•'n i ~r~i TeX s BY -
' -r y ~`7
' / P3eputy Clerk
% ~M .:=`-'c`•`,,~ • .
- 4, ~ T.~~~! S C.~
~ ` ! G J`.~{ ST. ' .
. . , , eo~K 67~ PACE2003
~ ~ .~:.4r_~~.. . _ - _ _