HomeMy WebLinkAbout0750 ~letl~llmit~n Zw^~~ ,w
STATE OF FLOR IDA 1 O 2 2 Q S 8
COUNTY OF ST. LUCIE
This is my Declaretion Doalcl~e 1~ the State of F~.orida that I am filing t
day in accordence and in.conFoi-mity vith SECTION 22~.I7; Floride Statutes.
, ~
I, (~le), 5' t~~t C'U ti
. p eese pr n•yaur name c ear y
became~a bona fide resident oF the State of Florida on~ 19 ~/f'
•and ~ reside et ? Q+~,p ;~,~LK
~
~ in the Ciiy of r~i__ ' ~t~ _ ~~/9s-z
,
My mailfng address is: ~ -u ~ '
f eren rom stree a ress
My former legal resfdence was in the City of ~/f, G, ~
,
State of f~'/1 l:. t,~..~<<> 7;~f~~~ • ~
(No further statement•is~required. Eiowever, if you wfsh, you may insert a~
pertinent facts such.as eale of property or business or relir?qnishment of
employment at former dot~icile, removal of Fa~nily to rew dot~icile, purchase o
, s
home, etc.) . •
I FURTHER CER'2IFY I~ill comply afth a].1 requirements of a Iegal resident
.
this State. I underatand there ie a penalty for perjury;perjury is a Felony
and~is punishable by fRCarBtion in the State Department of Corrections.
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J~ 1 ~C(61 ~2~ E'~~ ~t.,r_1_•Rn~~ ~.7~f ~
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PRINT NAME ~ SIGNATITRE
. ~
PRINT NAh~E ~ SZGNATURE .
Sworn to and subscribed -bafore me th~s ~'~dey oF ~ ~,~ti~~<< , 19 `~1 r~
ISQUGLAS D ~~~RK CIRCUIT COURT r-
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eputy sr
R~CORDING INFORMATTON
;~otazy pub~ic, stete of ~ I 0 2 2~J 5 3
My cc~rmissiori E~cpires: ~ . . .
. ~ '90 JAN 29 P 2 :5~
t d+~
. . . Fl~c - , ~E`
,
fseal) ' ~ ' t~OU~,!-^ ~ '',xGh ~ -
' Rec Fee 3 . t~flUG1.A9 DDCON ~ ~ ~ ' ` ~ j~ ~ '
Add Fee j___,. SG Lucie County
Doc Tux $ Cl'erk ,j~ Circuit Coutt
Int Tax ~ By .
1 Deputy Clerlc
Z V G8 t $
. . . , . a U 75 r~c~ 750 ~ .
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