HomeMy WebLinkAbout0176S~~ 1 228
Declorotion of I~oniici~e an~~~~i'zenship
TO THE STATE AND COUNTY TA8 A88B~980R.
8eiat Foie COUNTY. gtpgIDA;
This is ml- decLratioa of Doznidle sad Cltis~enahip- in the State of P7orida that I am !!line this day in
aoco:dance, and in conformity with Chapter 282, Section 282.17. Florida Statutes.
i was iaasaerly a keel reddest of lTorton __ ~____~____ ____virginia __~_____
ca~i~ gorton, ~~ cetat.)
and I resided at___l.iTa~___1a_ ~,ae_.., Y11,_._~.J111e~__StQi___. However, I have changed my domidle
(8tre~t sad Namber)
A K:s~ :ss~a. 8::~ }data ~c--}.~. 3 ~.~..° }4t1~ ~~~~~ ~~ ss.~ .~`,Yele n# ~z!~frls 4fT.l!a fat - '1-''=q s~#
D~osmber _ ~ i8 dam, and i reside atw~~a~4~a A_~~Ind._ Hilid Dr _--
«~.c .~; xfw _~ ._
lr't.Pierae St.I.nois r..„„w a,,..~,,e
- ~~~
and this atatemeat is to be taken as my dedaration of dtisenahip. actual legal residence and domicile is
the State of Florida.
((Invert bug say psrtiasat faeta. such as sale of pertx or boaiow. or reliapuleba~eat o~ emao7awat at
forawr do~idle. eaa~o~d of tasib to nes da~feile. paxASU di bore. fie.)
Pwrchased a sew hoes
91185
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I FURTHER CERTIFY that I will neuter ax nUr bcal addraa when the registration books reopen,
and comply with an other requirements of a keal naident of this State.
I ;:"l,'RT"~~ CERTIFY tt~t I ha ve ~ iniantl~ to s to a~ Yoraner +domidk. and I in xnd to zemaln
in. F~2~ Pisre • Bt . Iate i e
try (ab) _CoontyY. F'1m'ida,
pea~manen
Harold D. Slon~'"l
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p`~ uuuurur~~E~_,~w~
Swam to sad subscribed b~ae~s ar .dy e[ ;~~;~ ~~~~~~`~' 3 ~ ~ ~ r.;
c l ~' ~ _
Tamar
A. D 18r.~ ~/
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Notsq Poddis stMe ei >!'loeYa as I,s~a ~: 4s ..; ~ . . , -r _
Yy Cooamisdos ~_,_,daRe 1~' lsib~ o'.~,'~ ,%~~_ fir. • ~ ~ ^ .
\.~ ~ d awi di~kd lle~ ~ Q~llk ~-. v.,~ wsiw iii
a+... isN17 ~. rl.~t City. 1"1~.
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