HomeMy WebLinkAbout0234~,
Declerat~on Qf D~icr~ and
TO TH$ BTATN AND C9UNTY TA7[ A$BZ88pili.
8'l.IIJCI= OOVNrY. lrl~OA1DA:
.Citizenship
This is my declaration o1 Domidk sad CI13semhip in the Stab of Ploeida that I am lWas this day in
accardance, and in conformity with Chapter ~, 3eetion 885.17, Florida 8tatnbs.
I was tarmerly a i®gal rellid~t n* ___ _ -. A~ ~~ ice! Qe O~T~i a
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andl resided at__--__117_ _Briaroli~~ i~t~fi l~.E.-__----_-_-.__. However, I have changed my domicile
csar.~c toad x)
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.., w•u ~... wau «..va w.cu 3. wuw arwf aWl.uouY Va bLd ..yN160 Vl ~lV!°Wa il11Oe--------L~-~It1~--------------------(~ai1 Q~
-- ----- ~1iglLat _ ____~, Ia ~ , and I i~esitie at~~2+~ ~ ~o~ ~T•~ i°+'ji ~~i- Pa~~-
(Strut and Naa+bar) --"".._.._-_.
Dart Pieros ryry~~ Bt.Iuale ~~~, ,
and this statement is to be taken as my dedaratiem of dtis~ship, actual legal residenes and domicile in
the State of Florida.
i r~mts do~miefl~i. ~ ~ ~ toto n ~dom~eik. q~h~ oot. ~e~~°t at osploys~at st
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I FURTHER CERTIFY that I will register at my local address when the registration books reopen,
_..a ...,.,-~~:..a:t>;. Ott r~~-- ---°-;~F~~~=~= t ? -t - -' ~ s =- a•
----_ ----~-: -•--- ~:: --~_.:;:.~.. ., ..;..~ :..:. ,csos avo;Gcu• Of %l-iw ou'ite.
I FURTHEF. CERTIFY that I have no intention to return to my former domidle, and I intend to remain
in___ l~crt- Pierc e_`__-_-- ----------.3t . Lno ie ~-----------w-~`y, Florida,
permanently. (pts)
- (Name)
•]t red B. 8ohaohts Sr.
(Addra»)
Sworn to and subscribed helots Ina thia._ ,d -__-day of
s ':' c _
o~S Pa611r + ,, ~ I~
My Commission e~t'as~,± t'~~,~;~:. ••%~/~1 /43
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(To M rzoentod iii ~dovikib atid`~setdaal sbd wkh C>.rk (~+esit Court. sad doplkato with Tax As~esoer)
8o~en BnDD17 Ce., Phut Ctq, lla.
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