HomeMy WebLinkAbout1387 ~ttttt~tttlan ~rt ~cn~~~~~i~
STATE OF FLORIDA j 4 2 Z 3 41 , ~
~ • C4UNT'Y OF ST. LUCIE . ' ' ~ ~
This is my Oeclaration Domicile itt ~he Stete of Florfda that I em filf~g t
day in accordence and in.conPa3~ni~Y with SECTION 222.1?~ Florida Statutes.
Y, (We~, ~ ~l
. p ease pr n• yo r nea~e c ear y
.became'a bona fid~ residert of the SCate~oP Florida on 19~
•and I reside et _~~7 lV ~ti! c%,~,i ~ C- ,~'_-t-
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~ in the City of~,~, C. C_-- i_ l~ ~Z_..- C?_
My mailing address iss ~
i f eren roai stree a resa
My former legal residence was in the City oF r v,i ~a~_
S t a t e o f '~`T" „ • ~
(No further stetement~is~required. However~ if you wish, you may insert an
pertlnenC facts such.as eale oF property or business or relfnquishment of
emp2oyment at lora~er domicile, removal. of £araily to new domicile, purchase o
home, etc.) . ~ •
.
I FURTHER CERTIFY I vitl cot~ply vfih ell requfrements of a legel resfdent
this State. I underatead there ie s penalty for p~erjury;perjury is a Felony
and~is punishable by inceretian in the Stete Department of Corrections.
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PRINT NAME S GNATURE
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PRINT NAr1E . ~ SIGNATURE .
Sworn to en subacribed -before me thie -,~~=,,,F,---day oF , 19~~'
AI~ON RCUIT COURT
B ~ ~I ,
, eputy er j
RrCORDING INFORMATION
tvotary Pub~ic, state of ~ ~ ~ 0 2 2 3 41 ~
My c.crrmission F~cp~ires: - • ~ ' ~
. ~ '90 JAN 30 P 1 :51
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e nOUGIr~B DtZQPf ~OU~ E: .,,N i`~'.
~ , . - Sk Lucie Cotutl,~r '
' 3 ~ ~ Cluk of Circnlt
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