HomeMy WebLinkAbout1625:..;: 3~ -fig - .
Decforot~on , oaf , . ~ # ~~ ~ o~ Cib~~bip
TO THg STATE AND Qi~INTY TAZ A
8'!'. TAiOIS t~itna~r, s
This is m7 declaration et Domkile aed ie the State os Fioirids that I am ~ this day in
aocordaaos, and in ooaiorsnity with Chapteir ~!!, Section >.>C8.17, Fbrida Statutes.
I was iormerl~y a 1e~a1 reeiaent of *~-•~"~ ~ ~orldsi -
(Ctta) (dam)
snd i resided :t .., ~cute__ t__Lez S'1~ .~____ .~-__--------_---. however. i a,;lva chimed ~ d
(~tr«t a>d xa~brr) _ _t,,,l.~ 4th
---------------------------------------- -----.da
to and am and have been a bona fide resideei: ni we 5:.:~ w ~~~ ~ )'
--- ~ebraciry ~ I9 ~ ~ and i reside a• ~ 01'tt>~ ~~e• *• Rt.8 Hoak 4lfS
(etsrot aid xonlb~e)
--?port Pie>~ee '~ --. _ ~. I~iois ____Cotmt~r, Florida,
(txtr)
end this statement is to bs tsken sa my decLration o? dtimnahiR acted lssal tesidwoe sad domicUe in
the State~~of~Florida.
(~ hero w D tam. ~fh ~ Halo d .~ OtiilO~s~. arc [~r1~Y1~~~ ~~ w ~~I ~ ~:
f07'wr dotlielM. romo~al of faslib to 1»w do®ie~. ~ ~ yoMr ~•)
Entering one ohild Very XaaCooY in pdblle sohool.
ND RECORDED
Fl~E _
~N BOOK
loci FFR -6 QM ~~' 2 ~y
RT ~,>E CDUI'm,c~p`~
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I ~-I,tu~FR rERTIFY that I will reQiater at mY 1oca1. addreea when the registration books reopen
and comply with all other requirements of a legal resident of fuss State.
:_~.._~ .
I FURTHER CERTIFY that I have no intention to return to my former domicile, sea ~ au~,c,au ~,o ramz2n
Dort Pieroe
permanently.
(aa)
~~:x~- ;
v+ -qty ~•1.•.a~i,u•~f;`i~!>"~~`T/"..i'
,~ ~ [ L •4 _
St • T•~q4 ~ _,__`____ _Connty~ IAOrida,
~__~ILl' _______._____~____
(xaaw)
Y. Z. Coot
(Addlws)
Sworn to and subecr3bei• lb•n~d.~-'~ ~ ~ ~
___ - ---Y----~ ~ r::r ---
My Commissionezpires ~"' ~' ~ ~ ~ ~ _
(To b. esoentod in dllnikato and oriRioal filed wkh C1o:t Ctreak Court. ssd ttapikato with Tae Apwos)
Bowen tidDD17 Co., Plant pq. ITL.