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Declorotion o~Ti~bIN~T-'=Citi=anship
TO THR STATR AND COUNTY TAY A$SS880It.
$t. ~+~is COUNTY lZ/OBIDA:
Th4 ~ ~ ~~~ ~ Domid~e snd GYt~eaship in the fitate of P7orida that I am lliin! this day in
aooordsnos, and in ooa~iormitr with Chapter 288, fiection 4.17. Florida 3tatntes.
Oedhao -
Masa.
I was icemerir a leSal resident of (d4) ---~ -- (Stag)
and I t+esided at__.__~--~111~0- - -r et - __--------------------• Howsver, I have chaaSed mr domicile
(Strict asd Nna-b~)
to and am and have been a bona lido resident ~ the State of Florida aince__•___--20~-----------------fir of
October , 19..b1.., snd I reside at161~--GaaLsaa-~o~r~--~-ur'-b--c~-'-----
.ed x~I
3t.I,uc ____County, Florida.
________
caa~
and this statement id to bs taken as my declarstian of dtiseaship. acwul ie=al reaidenos and domidle in
tbn State of Florida. .
((In.azt >r~ :w v.rtiwat leats..oe]. ~ ,al. d _~ro~ ~ ~~°i'Lm'°t o~ a~p~Osm~.t at
forrer do~kisw rid ~ las~ib to ~ww doae~~dle.
Eatabliahing residency
-_.-
101546
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aGEa Po~Taas.`~
st. ~uciE ceuHtY. F (3~
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I P'UBTIitNB CERTIFY that I will register st ~- Iocal + whoa the re~istrattan bodca reopen.
and eompb with all othesr re4niretaeetb cL a ksal rasSdent c~ this Sit-ts.
I F'[JBTSRR that I ht-~a ao IatsoMao to ietorn to aV tossastr doanidle. and I intend to remain
Fob p{ w„~ ~ _ atr ~rL ...a ~ ~~~ ~~~
taws ~
• - ~ -
e ~ ~ Clifford C. ~hh ~ I '
' - ~~ un .
b1#a~ as thi~s.~r,...--de7 ~~~r~ ~, ` ~ . 3 ~ ~ j, "
Sw~ to and _ .~`~~ 1~ `~ y~ '~
L ~ ,rt- , ~
ass. st.. -: ~' ~.
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