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Home My WebLink About0607i 696 Declorotion ofSTDo~n~ici e~an~~Citizenship . To ~ sreTS wr1D oourrr~r T~-z •asas3eox, ss. ~tu~s oot>~r. ~~-_ - Tlii. is ~ declt.ti~ a~ nanidls sad Cltiseaahip in the Stt• of P'fo:id+- that I am Aling this as3- in aoooidsnce, and in oeatoarmity with ~ c~spter ~. Section Q82.17, Florida Ststntes. . ~n Ne_. Tork.______:___ I was iccme~ s legal resident os__.._Ar~ t (~) (sta) - 1600 •lbe~erle Goad _. --_-__-• However. I have chaaged my domicile :,d i r~ ------------ - - - -- - -- ---~ -------- - -- -----may w ~_ a ....a ~.oP t~±n a bons !We r'CSident of the $bte of Fionda' siaoe-----:----- . w~iw:.'~i...... ~ ~.ca ~~1 ww±~ w Cnurt~P©]rt _.!?t~L:io1e _Ysj _ _ 18 ~'~ ; and 1 reside a~__ ~~ L~ (8a~ .oa Nambrr) - ,. ~'o!t Pies'o• 8t. I+u~ie ^~~._____. .~_CountY. Fiarida, --• (Cib) and this atatemeat is to be taken as my decLratioa of dtisenship, actual legal residence snd domicile in the SEste of Flosida. ' ttliw:t hose aw- vet tKts. wed as sob d yro~ d ~°Ti4e~t a[ enplo7awsi at tamer 8onkfle. s~a1 0[ taa~- ~° As~w bo~aie~e. _ 9~-4~1. _....ncn .~ n~i'ii{{iY~U E+~-F~ -~-ivv ~~-~~~~`~~ ~[ .fial~ i~~l%ra~"~"~~I~ It~G~R pal NRy F'IOH~CA ~Y Sj. LUCIE COU ~p :"' '~; .' ti ` .s': .w ~ • -- ~ c- • ... ; f • ~-~~ .` ~, I FURTHF1i C1~1`IFY that I will mister at n~ focal addrw wbea the re~tratia- books reopeII, _- ~ ---...~-. ~ all other reauireme+~tt ai a legal realdeat et this State. I FIJR,TH>i:B TIFY that I lsav+s ao iateai~m ~ r~turs to aa~- io~t:do~nidle, and I intend to remain _ list Pi~ro• at. Ixei• Count~-. h'loelda, (~) • - - ~ lam) !. !'N3f , - : - - iAiiee..) 8waea to Fwd ~' bedq~ pee t1Jr`..,'3~.'dy~ .at ~ - ~ ~ ~ `, . er~.,w eceess p. r4wt ~t•' .. ..