HomeMy WebLinkAbout0509 _ ,~detii~tA~,an ai ~vamu
S7ATE OF FLORIDA 2421901
~ • COUNTY OF ST. LUCIE , '
This is my Declaratioct Doc~icila in the State of Floritla that I am f iling tl
day in accordance and in.conformity aith SECTION 222.17; F2orida Statutes.
I , ( W e ) , ~.b
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p ease pr ~~your n~me c ear y
became ~a bona fide res3dent oF the State of Florida on ~r ~ 1 j~' i9
•and I reside at I'~ ~ ~ ~ _ t v
~ in the Ci Ly of r~ ~~S c~? t~, r"} c--t-t ~ =~-t=~1~- 7
My mailing address is: ~
i dff eren rom street a ress
My former legal residence tias in the City of ~1~E- v~ ~ ~-J
State of i~t_ :~~1 • ~
(No further sLatement.is required. Howeverr if you wish, you m~y insert any
pertinent faets such.as sale of property or business or re2inquishment of
employment at lormer domicile, removal, of family to new domicile, purchase oE
.
home, etc.) •
I FURTHER CERTIFY I~ill comply s~ith all requirements of a legal resident ~
this State. I understancl there fs a penalty for perjury;~erjury is a F'elony
and~is punishable by fnceration in the State Department of C"orrections.
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PRINT NAME ~ Sx~ TURE
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PRINT NAtfE ~ SIGNATURE` . `
Sworn to and subscribed-before me this •~~day oE~~ w~. 19 C~
,~OUGLAS D,~XON CLERbC CIRCUIT COtTRT 1
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RrCORDING INFORMATION
t~iotary Publi~, State of 9 '`f. 1~Z 1 9
t~,y Carmissiori k~cp.is~es: - - '`~0`~'~ . ~90 .1AN 29 All :11 ~
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. . DOUfi_ aS C~~zGh ;w~
C.~'Bl~ ~ S1• ~t'~' •r.~l~l~ .
Kcc FcL ~ L)OltGLr~S DI\ON ~ ~
~~dd Fee~S St. Lucie C~~unty.
f~;~r 7:i~ 5 Clerk o,~j Circuit Coust
1~i i Ta x$ _ Q~%? J,~C~ _ .
De~uty Ckrk
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. . EaG~675 p~E 509 ~
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