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HomeMy WebLinkAbout2117 ~ . ~ ~~lurrti~n ~i ~omtrri~ STATE OF FLOR I DA 10 2 2 6 d 4• COUNTY OF ST. LUCIB . ' ~ ~'his is my Oeclaratfon Doroicile in Che State of Florida that I em filing t day in accordenc~ and i».a~ttifoi~ati~y t~~th SECTION 222.~7~ Florfda Stetutes. ~ v ~ ~ ~ We ) ~ ~iG .f ¦ r - - r ~..~.r~. . ~p eese pr n~your neme c ear y became ~a bo~a fide resfdent of ths State ~ oF Florida on ~~r,uc~~~ 19 ~'"y' ~and I reside et_„_xh~> ~ ,~,L,,,_. ~1~,4!Y ~~l~~a 1 c _ ~ in the City of r~` 1• X'- LE- l= i 3~~''~L~ M~ ~ailing address ~s~ ~i ~ Sc~ , 1~ S. ~ SL t`~ ; . - - ~iL ~TiL~CLGtfY :i~M ~__ress_ . My former legel res~dence ~es fn the City oF ~~/~~Q~ StBt~ of ~ y~=c,u - ~~e ~ • (No further stetement'.is required. However, if you wish, you may insert an pertfnent faetg such.as sele of property or buainess or relinquishment of employment et lormer domicile, retooval of fa~a3ly to new domicile, purchase o home, e~c.) ~ • I FUR2HER CERTIFY x~~.11 co~nply `?ith all requirements oF e Iegel residec~t this State. Z underaLend there fe a ena2t for er ur er ur is a Felon P Y P~ Y;p j Y Y and~fs punishable by incaration in the State Department oF Correc~~ons. . - ~ . ~ ,S~- J / Y ~ ~ /~~C~ C'(.Y , ~G'~ ~r ~ ~ ~ ~ ~ C' • ' s PRYNT NAME 'SIGNATURE . . ~ PRINT NAPtE ~ SYGNATURE . i i Sworn tca a d subscribed -before me thie _S ~ ~ dey of ~C .L~~ I9 ~ DO D CIRCUIT COUItT ! B,y' - 1 , ep y er RrCORDING INFORMATION i,btary Public, State of ' 1Q2264d r•fy cc~rmissiori bcpires: _ - . . ` ~ ~ ~~o ,lA~ 31 P 3 :36 y~ 6 • • ~ ~ ~ L C y i1 ~ e- t~ i' . f.~e.al) R« F-~c s_ J~ u~~~c;~,~s u~xu:v OQl1Gt X;,t+ v • lclci Fec 5. St. (.ucie Ce,unty S1. L11+:+~ .,1N i', ~~R ~ ~ 4)~~c Ta~ Cicrk of Circuit C~>ur . ~ y i ,~jvr „ Inr Tax 5 ~.~L , . Ucruty Cicrk , i 1'~~lnl S ~ C . . t'`~ `~'a.,, ' ~.~'A` ~r*?. ~ ~ ~ ~ ~ B~~K675 e:~~E2117 : : _ _ ~ v