HomeMy WebLinkAbout0508 ~det~rnri~a ~wum~r~,x
SrATE oF FtORIDA 1021900 ~
COUNTY OF ST. LUCIE ' ~
This is my Declaratioct Domici~e in the State of Florida thet I am filing tt
day in accordence and in.csonformity vith SECTION 222.17; Florida Statutes.
I, ( tJe ) , ~ f ~ _F ~ t .i1/ t- .//~c. c.~ cl ~ / 2~.~
p ease pr n~your neme c ear y
became~a bona fida resfden~ o~ the State oF Flor~da on 19
•and I reside at /a?a f S T/~A iIr G
~ in the City of ' T- ~ ~ ~
My mail~.ng address ~ss ~
eren rom stree a ress
My former 2ege1 residence was in the City of ~3 ~~a~~~ y r
state of ~o c~~.e--~~ • ~ ~
(No further state~en!'.fs required. Elowever, if you wish, you may i.nsert a~y
pertinent faets such.as aale of property or business or relinquishmenk of
employment at fortner domicile, removal of family to rtew doraiciZe, purchase oE
home, etc.) ~ ~
I FURTHER CERTIFY I vill co~Aply with all requirements of a legal resident ~
this State. I understand there is a penalty for perjury;perjury is e Felony
and~is punishable by inceration fn the State Department of ~orrections.
l~~~c,~!_F~Eial~ ~?~i~„/~-~~,
.
. .
PRINT NAME SIGNATURE
<
c ~ ~ A ~ ~l AC C~, v~ ~ i
~
PRINT NAME ~ SIGNATURE .
i /
Sworn ta d subsc~i~ed -befor~ me this _~~day of -CZ~ , 19
LAS , CIRCUIT COURT
/ ~
/ !
e uty er
~e~ + RrCORDZNG INFORMATION
i
:~taxy Public, state of 1021900 ~
t~,y ccxrmissiori ~cpires: . . :'90 JAN 29 A11 :10 ~
t ~
r ILEL ~~i YE~ ~
' ~ / • DOUGLt~; C~i!!Ok ~
C~al) Rer'''__ ~ (/~_:)OiTGI.A3DIZOPI Sl. ~t~~~:~ ~',1?~, •T
, ~ , A• . ~ , :a - St. I_~cic County ' .
Doc Tax $ Clerk of Circuit Co
,~i . = ' . Int Tax ~ By
. ~ . Totsl i ; G _ ~v~?4? Cl~ic .
, . ;
<
; .1: _ .
. vti•. - ~ ~ . i
' f
BOGK 675 PaGE 5O8 • _
~
~ s. _ d _.u. _ < ~ ~ _zN..~~~