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DECLARATION OF DOMICILE
STATE OF FLORIDA
COUNTY OF ST. LUCIE
This is my Declaration of Domicile in the State of Florida
that I am filing this day in accordance and in conformity with
SECTION 222.17, Florida Statutes.
I, ( i~ ) Newman, Edward R
(please print your name clearly)
became a bona fide resident of the State of Florida onrtarch 1 ,
19 89 and I reside at 3114 Sunrise Bv ~
in the City of Ft Pierce, F1 34982 .
My :nailing address is: Same . .
(if different f rom street address)
.Y.ir r::rr..cr 2 an~ 1 rcci r~~r.r.n :s~a : r> >-}-~o f~i t~r IT_!~1?R2DOZIS
.:i ~~..y..~ a......~.r.....r.. ,
State of IN ~ .
(No further statement is required. However, if you wish, you may
insert any pertinent facts such as sale of property or business
I; or relinquishment of employment at former domicile, removal of
family to new domicile, purchase of home, etc.)
'90 JAN 26 P 3~O 1
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~ I FURTHER CERTIFY that I will comply with all requirements
;
~ of a legal resident of this State. I underst~nd there is a
! penalty. for perjury; perjury is a felony and is punishable by
incarceration in the State Department of Corrections.
Edward R Newman
PRINT NAM~ SIGNATU E ~
PRZNT NAME SIGNATURE
~
Sworn to and subscribed before me this 22 day of January ,
1990 . . _
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DOUGLAS DIXON, CLERK OE' CIRCUIT COURT
V•'•
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BY: ~ p ~1 'o
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Deputy Clerk ~
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Florida ' `::.'y,''~''`
NOTARY PUBLIC, State of
NOTARY Fl!BLIC STATE UF FLORIDA
MY COMMISSION EXPIRES • KY C~`'~ISS.ON EYG. OCT.13.1993
- • _ , „ .'~S. UPID.
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