HomeMy WebLinkAbout0138- sr. ~~ cauMrr. ~~.
Declotation of Domicile one ~i~izenship
TO THE STATE AND COUNTY TA% A88S88Ax,
3alat Luoi• COUNTY. FLORIDA:
ThL i3 my declaration o1 Don~idls and Ciip in the State o! Florida that I am Nina this day in
aooordanoe, and in conlormity with Chapter 222. Section 222.17. Florida Statutes.
I wan lormerly a !anal resident of_-- SouLhBoBto~- ___.-.._-------_--..------___-. ---------------- Qjrgiaie
(Clt7) (stet.)
and I resided at-_...-18Ea -Barbour Stre.~~r-__.-____________ __ ___--. However, I have chanaed my domicile
(8tteet atW Number) -- -- - Q a !
s -, - -~ .l ~ !, w p l+n.+*. ui°v :~e3~~wz ~~' f~. ~ci4~ro !!T ~lQ!'1123 !!l11CC' ~~Yh ---_- u$~i QYl
{~ t~ju A1ii QiiGi i~Tii F/r.iaa is Yvw -... -
-- S~teaber_______--__-___, 18 6th And I reside at.----.1Q$~~~L._Iadia~.8i~ta~_~2r_.---------------------
-----~'ort_ Pizrce-•__-- -___., ._-___.~.Lnoia_------------------------County, Florida,
cat,)
and this statement is to be' taken as my declaration o! citiz~ship, actual !anal. residence and domicile in
the State of Florida.
((Lwrt bsrs an7 psrtinwt !eels. sne>t as sale o~ pest or bnsiaew. or relinpolsbmsat oS smnplo~rmsat d
foresa doa~idb. ramasal oZ lamb to new dcmleiN. p~ebeas a~ tioaw..~e.)
Purohesad a hone here
91.154
FILEC hT~0 f'ECORJED
u.an
f J
~~.J.,ch FOITRhS. CL=..:
Si. LUCIE COUN11', FLUn~~A
_1 -
`
. ;.
•
. , ~
~
-
~.,
,•
~T• i.. .
~1
~
~' f,
~
.
"~u~....,,.
I FUT;THEIi CERTIFY that I will resister at my 1oca1 address when the resistration books reopen,
and comply with all other requirements of a lean! resident o! this State,
r rarrDm[rt~O nL~DTrFV i1..t T 1.v~ ~ i~~r~Nww M r~~ :~ tormMr 8~ T +"te71d t0 rsww.in
a r Vt~aaaay~. vw.... wr ..... ...r .~ _~~ s .u ~.....r...
~ Fort~~eroe ~
(ab) -.--"' e_._.______Coanty. Florida
perraaaentll-.
Sworn to and subscribed baas+e me tbis~.__.._daT of • ,.•~ };:.3~~, tAdirees) ____~_
Ja nun A. D. if.._.l~1 • "~' ~~ ~~',~
~.>sisteer phhWb Staff ~ lheMs sa I~ !~ J 3 0.. ` ~:~, i
:..)q f
][s ~; tnea .tZIIUL 1!3 ~ 19 ~L., ''Y f t:~~ ., t^ *14,
.i.,..~~ ~ ..r`~:
~s'e be uwate~ is ~Ma/e aai eei~lad fiN wtt>t Galt Okre1C'
s.... t~s cam, r+..t aes. s~.. _ -
wftL ~ Aaewoe)
.,
~~