HomeMy WebLinkAbout0129s~, ~ ter. ~~,
Detlarotion of Dooeicile and Citiz®nship
TO THE STATE AND OOUNTY TA8 A88St31308,
3T. I~IE LOUN't'Y, l~'LORIDA:
This is my declaration of Domicile and Citiseasbip in the State of Florida that I am lllin~ this dsy in
soco:daace, and in conioranity with Chapter 228, Section 222.17, Florida Statutes.
I was io~rmerly a la8al raideat of__ZOA'!f.__~_______--______---~-_---------------. ---~~~-~.
(G4) (8tsta)
and I resided at___-1Q3~_-I.anOaiL.ea--~-r~~..---------.------------------ However, I have chane~d my domicile
(Street sad NnmMr)
tc arsi aza and hn~ beez! a bow ids resident ai the 8~tc of FMrida since-------1~_--.--------- - _----------day of
._Yarab _ 190, and I reside a~ 1908 Coral Avenne,-- Parq~s~-- P~---
- -------_--- ----~ (Steeat and Number)
Dort Pieros 3t. Lucie _-~-_-.-__._County, Florida,
- ((fib)
and this statement is to be taken as my decburation of dtisenahip, actual le8al residence and domicile in
the State of Florida.
(Iiwrt Lae aa~ p~rtiaant taco. sueb ~ sale o! part or buaioas. ~ reltnqulahm~at of amalo~moat at
former domidie. remoTal od tamib to now domie~a. par~ebasa e~ Lose. Abe.) -
91148
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I FURTHER CERTLFY that I will resister at my kxal address when the re;isttatlon boats reopen,
and comply with ail other requirements of a legal resWeat of this State.
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Sworn to and sLb~r3bod, pda~ aer tbLr * dy ad
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