HomeMy WebLinkAbout1194g~x 2 ~5 -
Declalrotion ofST~oinici~eTOn~'Citizenahi
P
TO THL STATE AND OOUNTY TAZ A$8~>i'ASQit.
LIIGIE ppv~y, ~O,gmA;
ThL L my declaration of Do~nidle and Citisemlhip in the Stata of Ploeida that I am Luc this day in
acxordance, and is ooniormity with Chapter 2llg, Section 2>~.17, Florida Statutes.
I was formerly • Issal resident of____. ~A~__B,I~Xi~---------_-------------------------^, -_~__-___--------------
(~) (Blab)
and I resided at-_-__- E00__Yir~lIIi~__8~~-. _----------------- --_---. However, I have chaaBed my domicile
-- (Strout sad Nnnbor~
to naui ~m and have been a Dona lfde resident of the State ~f Florid± since.------_---~~~ -----------------------day of
_ 19_4Q, snd I reside at_______~g~_$ - _ _ -- -- ---
aad ~Tuun~) ------ ---- - --
_-- -----____-- F'T.-PI=BC- E __--- --. ______g'1'~S.tICIE._____~_._.__.~_______County. Florida,
-- - -cats)
and this statement is to lie taken as my declaration of dtitsnahip, actual legal residence and domicile in
the State of Florida.
tormorr domieiler riemo~al of lamil~ to now domi~pnxhaoo o~ ~~, os~r~iitpnlsbsa~t o? oanylo~m~at at
- . ~s5s
FILE AND RECOR ED
Iii _. 800K
I~o~ J-?-~ 27 1~'' 9:46
1; 1 L E R POITRAS, CIERK
Si.IUCIE COUNT'f,FIOR~GA~~~
~ ~~'
'~/• `n ..
,, ;•~, .
i L~ TDTLITT) (`T. ATTTi`V tti.y: T .qi ro •tE- t TM~ Irval Aririrv_~aw WhPTt ~hP registration hooka reopen,
a P "v i~a~aa-.ate vua~aa~ 11 -e - r a-
i-na comply wiiii 811 utnrr Pit"~iilYcaTtBnta Gf 8 isgai rWiticilt oP Ssia Mate.
I FURTHER CERTIFY that I have no intention to return to ~- former domicile, and I intend to remain
ia--------FT~__PI,E8G1~---
cc~t~l
permanently.
,.`aV\)~~. CHG..
3yidm,to~l~ind`spJ~ii~ bt+fore me this---_~2---day of
=s~.EOz~tsroz~ cr~cul~ covKr
c ~~`;~
DIP. CLER>r
(To b. executed fr d~yliab and
H~~r-an 8uoD1• ('o.. Plant ('1tf. Pla.
clod wkh Qork (xrenit Court, and da~lieato with Ta: Aasosoor)
-- I-E--------------------- County. Florida,
--------
(Nana)
------4--RGIL. C . 1RL7~~~----------------------
(Addrow)
~f. -~~~ _
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