HomeMy WebLinkAbout0487~a6i ~ i ~ 559
Dotlarotion o~'~~11 CiHse~~P
To T8a s~rsTS ~D oovrrrY Tex a~asos.
str. Davis ~ oovrrr~. ~~-:
ZLis is aU- aeclantiou of Daaieile arW trip is the stet. of Fiocida that I am awns this day in
aocordanoe. and in conformity with Chapter' 8~4. 9eation X2.17. Florida sbtntes.
I was locmerly a legal resWeat of ~rrtni trrT1A __.__._ ------------
(0l4) ----. ---~- ~sqe.)
~/~p p~ - - - - ----- - - - -~
~~~ T ~i.i~..t q• ~W1f___/~.~---_'~_____..__._._._--___~___-. aVYiOTOi, a woo r+w'r"" "'~ -
~~ ~ ...~.~__ ~.. t ai08 iii
- -----_.._day of
to and am and have been a bona !We r+esid~t of the State of .F'forida sinoe_•------------y---------- - -
_}--
AIIC:ZT9T 1 reside at. ~i~ ~'oioniai w- _______-.
------------ ------------------~ 19- ~ and (8tr+st .oa Nnmb~)~_____-------
F't. ~ie~o• ,~ ~ 8T. LIICIE ~_w_~._.____~~_Connty-, Florida,
(CIt~L
and this statement is to be taken as my aecl:ration of dtisenahip, actual legal residence and aomicile in
the State of Florida. -
(Insert hero atgl Datiin~nt facts. sash u salo_ a~ ,pso or ~ y~ ~~~°t of osplo7~t et
tormtr dotafeib. tymo~al of tam3lf to tuw ~~
_.,ne.~rr ..... \
J1~~5
~~u ~.
I`~ _ ,~ BOOK
;,,. i.•~Clc CUUNT'f. FLUn~:1A AQ~i~/
N ... -
I FURTHER CERTIFX that I will register at my local addreaa when the registration hooka reopen,
_..:... _.~ ...:..... wd.nistiiriAnf, .~' 8 l~=~::~S3eat of thus q#ste.
..:rII LyZ::~l:}' •7t4se !+t~ vr..~.• .w•~•-~-_____ _-
I FURTHER CERTIFY that I have no intention to return to ~ former domicile, and I intend to remain
-8T.--LUCIZ-__~_ ___-----__~_County, P7orida.
-----
~------------1"-~•.-~----------------------• -
permanently.
.,
'~•~ '•;~' : ~ ,~~~ ~/~~~, - before me this---~-----day of
Sworn 1ri4. ~d 4w~+!;~;~
_ -
.n ,~ a~
~ ~'~~•
ate.)
Dep. Oleric
---- (To b~ ez~euta is danlieab and fled Tdt\ Clrrt (~aok Coact. asd daytia-a witti Tat isasssor)
fto~+w psvb C... PUat City. lla. .