HomeMy WebLinkAbout1386 . ~ . _ ~ ~ettut~tian u1 ~dmic~~e~
S?ATE OF FLOR IDA i o 2 2 3 4 0 ~ ~
+ • COUNTY ~dF ST. 4UCYE , ~ ' ~ .
This is my Declaratio~ Doanlci~e in Lhe Stete of Floride thet I am filing t
day in accordence and in.aonFo~cai~y vith SECTION 222.17; Florfda Stetutes.
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I~ (We~~ _ - c,?-,-~eS ~ ~ .
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, p ease pr n• your name c ear y
became ~ a bana Ffde re9ident of the State ~ oF Florida on- ~g ~5 )
•and I reside et %~-z Z c~~~~~~ ~2 Ac ~ A t~c • ~
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~ in the City of.,,~~,~ c~~. ; J,
My mailing address ist ~ '
~ eren xom stree a reas
My former lagel residence wa~ in Lhe City oF_ _Sf~e~ j„~,~ti~C •
State of ,~lf~~~ ;
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(No further statecnent ie~required. However~ if you ~fsh, you may insert an
pertinent facts such.es eale oF property or buainesa or relinqufshment of
employment at lormer domici~e, removal of gemily to new domiciZe, purchase o
home, etc.) . ~ .
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I FURTHER CERTIFY I t~ill comply aith al~ requfrements of 8 legal reside~t
this State. I underetand Lhere ie $ penalty for per~ury;perjury is a Felo~y
and~is punisbable by incereLion fn the State Department of Cvrrections.
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PRINT NAME ~ ~ SI~NATURE `
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PRINT NAPIE ~ SIGNATURE .
Sworn to an subscri~ed -bsfore me Chis -~_day of ' I9~'r~,
' CIRCUI2 COURT /
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RLCORDING INF~RMATION
Notary Pub2ic, 5tate of ~ 1 0 z Z~~ O
p.~, ' . . . .
carmis~iori ~cpires: '9~
. o,.. ~ JAN ~0 P t :St,
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2.~~~ F~•e S _ u~~u 'L ' DOlJG! rt . ~Gh ~
1k~ c~ AS DIXO`~l Si. LUT';- :~t:N;
i..J I~Y i 1 l~ l 1 f C r. v7
~!~,`~.~,.F: ~.C. _ St, Lucie C~.unty •
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; J~~c 7ax 5_~_ Clcrk of Circuit Court
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-Deputy C?erk
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