HomeMy WebLinkAbout2352- . ~~ 4 381 .
Declaration o~ Domicil ~~~~~
TO TH$ STATS AND OOUNTY TAZ A88l1~60R. -
• ~ OOUI~I'1'Y.l~'Ir0~lt3DA: .
This h my aeclaratiioo of Doo~idls and t~se~aship in the State of Florida that I am ~s Chia day in -
accordnnoe, and in conformity with Chapter ~8, Seatfon TtS8.l7, Fbrida 8tatntea.
I was formerly a ksal redd~nt of ~~!~ _. ffiGw1~
(dv) ~ ceae.) _
and I resided at__ ~_-~'wZ`t!.-_ ~-------__-_- _-_-. However, I have changed my domidk
------ -
(Strwt tmd Ntnab~s)
to and am and have been a bona tide resident of the State of Florida ainoe__-____-- -8~h----------------day of
---~_~~t~p.L_-___--- ---_----, 19~~, end i reside at_. 11*t~ -8sawaF Drive .
csa~..t .aa x~~~________ __.
!'ort Pisroe _ Bt.I•uoie _____Cflnnty, F~~,,
tGtii-1
and Chia statement is to be taken as my decLration of dtiseaiship, actual legal residence and domicile in
the State of Florida.
41~ dY tiTl~ pOit~Lftnt tOCta. ti11Cb Y ftalta Od ,~ Or ~OMta. O= T~tllib~Nlt O~ (tsy~07~t ~t
5071~t ~IC~IA. !'tam0~ 0~ ttti~~ LO M'w OO~CtM, p O~ ~tiMs (~Q.)
Sntering one ohild in pnblio school.
1- David Iynn Chaabers
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I FURTHER CERTIFY that I will register at n~q local address when the registration hooka reopen,
and comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain
• Dort Pieroe die _ __ ___-----______County, Florida,
m-------------------------------------------------------------• 8t ' - -
(cats)
permanently. ~~~'~t-~ _ ~___ N~ ----------------------
Clyde 1~. Chambers
Sworn to and aubecribe~ lie~Qi~.7All:~~,!t .-day of
- ~ ~16tarr PnWis spt~-.rii it J~Is'sr
l/ • . ,
My Commission es~., ' t~
(To bt e:~evtfid 311 fir
anw.•n B~.~uulr ~b_ Plant C1t7. Irla.
alas wjtb cast cash cOUrs, .aa dttyikaa .-ita rs sM..aoe)
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