HomeMy WebLinkAbout0829 ~9eclurnti~n uf ~o~micil~
STATE OF FLORIDA ~ O2 z~ O 3 ,
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~ COUNTY OF ST. LUCIE ~ '
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This is my Declaration Domicile i~ the State oE Florida that I am filing thi :
day in accordance and in.conformity with SECTION 222.11; Florida Statutes. :
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I, (We), i,~-r~~ -t l~c' . L~. ~1Y?~?~% x.~lf'r
p ease pr nt your name c ear y~rs,en -~?6~ •79 ~
became~a bona fide resident oE the St~te of Florida on 6~70 19~ ~
-and I rzsfdz at , ;v~~~i,c~_ ~~~~-c` ~ i
in the Ci ty of r ~f - .~~.c - . ~'35(9S 3
My mailing address is: X v~ / ~-rf- a t.~~ '
i f eren rom street address
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My f ormer legal residence was in the City of f~ ~ ~
State of ~/c~~ •
(No further statement is required. However, if you wish, you may insert any
pertinent facts sucl~. as sale of property or business oc relinquishment of
employment at former domicile, removal of family to new domicile, purchase oE
home, 'etc.) •
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I FURTHER CERTIFY I will comply with aIl requirements of a legal resident of
~ this State. I understand there is a penalty for perjury;perjury is a Felony
E and~is punishable by incaration in the State Department of Corrections.
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~ Sworn to and subscribed before me this _,~7~ rd day of ~ ~ , 19 ~D
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~ DOUGLAS DI~iON~ CLERK CIRCUIT COURT ~
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~ Deputy C er
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~ ~ - ~ = ~ RECORDING INFORMATION
` ?~otary Public; State of ~~.~-u~~~
ivzzio3
yy Cammis~~Y~~, E~X~~~@$: ~OTARY PUBIiC. StpTE OF F
' ' " ' 1990. '9p JAN 29 P 3 :51
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