HomeMy WebLinkAbout2659 ~ , ~ ~E'E~IJ~'2lfiAtt u~ ~ r^siac~,~c
s•fATE OF FLORIDA 1422918 . ~
~ • COUNTY OF ST. LUCIE . • • .
This is my Decleretfott Domlci~e in the State of Florida that I em filing t
day in accordence and in.aonfoi~tnily with 5ECTI4N 222.i7; Floride Statutes.
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p easa pr~r. •~?e~r name c ear y
h~ca:^~ ~a bona fide residenL of the State oF Flor~da on_ pc
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•and I reside at JSC S, r-,~ I S~ ~ y
~ in the C~ty of % s~ - ' ~t _ ~
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My mafling addre~s is: So /~i0 ~ s`,~ -r~
(i~ ~f#~ ~~~r~ rosn st~ee~ a ress
F!y f ormer Zeg~l restdence tias in the Cf ~y of ~'f1r~ F
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j~ j'~ ,
State of ~ t-=ii r" S- l._ . ~ .
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(No further stetemenC'.is~required. However, iF you wfsh, you may insert ar
pertinent facta such,es eale of property or business or relinquishment of
employment ae i~oriner domicile, recaova2 of femily to new domicile, purchase c
home, etc.) ~ ,
I FUFtTHER CERTIFY Y t~ill cocnply with aI~ requfrements of 8 legal resident
this State. I understancl Lhere is a penaZty for perjury;~erjury is a Felo~y =
and~is punishable by inceration in the Stete Department of Corrections. s
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PRINT NAME ~ S~GNA~URE ~ ` `
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PRINT NAPfE ~ SIGNATURE .
Sworn to and sub~cribed-before me this ~day oE , 19_~~1L.
DOU D7.XON, ~ CIRCUIT O~URT
8y :
- e cy er
RCCORDING TNFORMATI~N
r~t~ ~b~i~, state flf . 1422918
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