HomeMy WebLinkAbout0510 . ~ , ~ ~ec.l~tt~ti~n c~t ~
ST'ATE OF FLOR IDA Z d z 19 ~ z _ ~
COUNTY OF ST. LUCIE . ~
This is my Decleratioct Doaicile i~ Lhe Ste~e oF Florida Lhst I am filfng t
day in accordance end in.con.eoi~mity vi~h SECTION 222.17; Florida Statutes.
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, p ees pr n• your neme c ear y
became ~a bona fide residenti og Che State oF Florida on ~..1~ 29 ~J '
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and I reside et ' ~u - ~ ~
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~ in the City of - = L " ~ ~w~~- - - "
My mailing address is: ~ • '
E eren rom etree a ress
My former legel reside~}ce was in the City of ~I~~~_____,
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S t a t e of / ~ "
(No further stetetnenC~~is~requfred. However, i€ you wish, you may insert an
pertinent facts such.as eale of property or business or reli~quishment of
employment at iormer domicila, removal of family to new domfcile, purchase o
.
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I FURTHER CERTIFY I vill ca~uply wiLh ell requfrements of 8 legal re~sident
this State. I understand there fe a pen~Ity for p~erjury;~erjury fs a FelQny
and~is punishable by inceration in the State Departm t Corrections.
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PRINT NAME ~ RE
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PRiNT NAPfE ~ SiGNATUItE .
Sworn to and subscribed-befora me thia .day oE ~ , 19~
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I.pS D CIRCUIT COURT
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eputy er
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RrCORDING INFORMATION
rJOtary Pub~ic, state of ~ ~ 10 219 0 2
hsy cammis~iori F.kpires: - . . . . .
. ~o ,~w 29 ~ ~ 8
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DOUG!," ~i~(ON .
cs~.~~ R~ F~ s--~~C~oc~cL~s DDCON S~ ~~u;:;
. Add I'ee 3 - _..-'t. ~ . County . '
D~ TaX a c~~rn ~u;c co~c /
. . Ir.t Tax a ' By G/
! Total s ~ ' . U~puty Cleck
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. . - ~ ~ ~ 60GI1 ~75 PAGE 5~Q
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