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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 confarmity with
SECTION 222.17, Florida Statutes.
I ~ ~7~ ~ Harris, Frank 0
lplease print your name clearly)
became a bona f ide resident of the State of Florida on July 18 ~
19 87 and I reside at 359 Barraclough St
in the City of Ft Pierce. Fl 34982-7348 .
My :nailing address i5: Same .
(if different from street address) •
My fc~rmea- 1_P~a~ rpsi~ence ~a~ in the Ci*y of Thomasville ~
State of GA
(No further statement is required. However, if you wish, you may
insert any pertinent facts such as sale of property or business
or relinquishment of emplo~ment at former domicile, removal of
family to new domicile, purchase of home, etc~ JAN 26 P3:03
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t I FURTHER CERTIFY that I will comply wi~h all requirements
` of a legal resident of this State. I understand there is a
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; penalty. for perjury; perjury is a felony and is punishable by
~ incarceration in the State Department of Corrections.
~ Frank 0 Harris ~ ~
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€ PRINT NAME SIGNATURE ~
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~ PRINT NAME SIGNATURE
€
~ Sworn to and subscribed before me this ~4 day of January ~
a 19 90 •
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~ DOUGLAS DIXON, CLERK OF CIRCUIT COURT
BY:
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Deputy C 1 e rk ~1 r,
~ ' 5~~~-~- (SEALc) ~ J ~~`Y.,~``
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NOTARY PUBLIC, State of Florida , ~
% . F.• ~~li. $7i.°,c ('w= rlt,n..~A ' IN•~ 't
MY COMMISSION EXPIRES: :.v ~-~?.t3,t>~~?
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BOOK V~~ PAGE ~2O
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