HomeMy WebLinkAbout2658 , ~ecJ~rntian a ~vam~r~„~
STATE OF FLORIDA j z 9 j~
~ • COU~tTY OF ST. LUCYE . ' ' ~ ~
This is my Declaretion Domicile ~n the StBte og Florida thet I am filing t
day in accordance and in.cont'oi'mity vith SECTYON 22~.t7~ Florf.da Statutes.
(w~), Y_~~~~ ~ y ~ ~c ~ r~~, -
p eeba ~r n~ ycur n~~~ c_ear v_
.
becsr~e ~ a bona fida residenL of the SCate oF Florida on J~/ _ 19~
,
-a nd I re s ide e t__,,,,,~_o~ S.~ 1,~, 1~~,
~ in the Ci ty of QLf~,~ ~<< ~ .3y'~s~..~,
My ;nailing address is: ~
i d~f ~r~n ro~ stre~ ~ ress
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My former legal residence was in the City og_ ~es.f ~~~-f~r~~________
State of /~~~,,~;5 ~ o y.~,i~ • . .
(No further statement is required. However, if you wish, you may insert ar.
pertinent facts such.as eale oF property or business or relfnquishment of
employment et lor~aer domicile, removal of fami~.y to new domicile, purchase o
. .
home, etc.) •
.
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~ I FURTHER CERTIFY I toill comply with alt requfrements oF a legal resident -
this State. I understarid there is a penalty for perjury;perjury is a Felony
and is punishable by inceratfon in the 5tate Department oE ~orrections. i
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S~or ~ to and subscribed -before me this ~day o~ ~-~-4 , I9 t~, '
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' ~ ~ RFCORDING INFORMATION ~
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i~otary Public, State of ~ ~ ' ~
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