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HomeMy WebLinkAbout0380 ,; ~ i)fl 302 a"il r:..~ ~.u t J De<:loroiion of Domicile an Citizenship ',i. Ll'CI[ Llhil, rl~. .... - -..... ---~-.------ . ... . 101m 5TATE AND COUN1'y' TAX ASS(~OR. .___j,\.. -1J....\.Qi~__ COUNfY, flORIDA Thl' it my ded.,'ol,on of OomIC.!" and (.Illeruhip If\ tloo :,1016 ot flofld4 th31 I om f"lf~9 th,s dill in .t,uotd4no:V and tr\ (onfoun,'Y wI,h Ch4plclt 27'l, :X-<.I".:;n 222 17, fior,d<4 5l/ltvtel WOI torm~rly /I l&yil ''''ldEnt of r.:'-m :'UG ,. J it C~.f e l"~ I..'Y ('Y-'_! ((.,,1 .nd I 'e\,dcd '" 26 Union :;trecl.. (\h~' and ~l t-\o"" 0'. tH , I h""" ch4f1ged my dOfl1,(t!e 10 and 1IfT\ Ilnd hll\ll!' l>t!-(!o /) tX>fIlJ f,de 'tHldi!ln! of the !)I.s'~' of floridA sinu, 3 dllY uf DeCClnh0r , 19 , 61, ~nd I ru!do ot :~l~ ..t. lucic :,'j,'nun n"H' ..-..d N.~l Fort 1. i tJ'ce ~ ___________ .--\.. ~i;ci C (OVnly, florida, _. . _ _ _, _ _,4 ..... _ __ _ _ _ _ _ - - ((iI, i lInd thll sl!llernl'!n! ,s 10 be I.!Jkl!n (l) my d~.dllr4',on of ("'HI(H~tlp, BctvO! \(.~pl re,id~H){~ and Jorn\(de in the ~lil'!; 01 florkh, , (t~t ....t. .:"'tJ S:"'ft"rlIfJ":t 'M~", ;".1'ih .. t,.,f~. <'~ (}l"C,",.'.,- 01 t.....'.......:l! C-I ,.!~...: ,~i"',f o~ ..~~tcJ'."...l'ti ., f-:"tll"f\.t, ~t(t;'" 1'.....,.~1'.! o' ;~~;', '0 ,.... <>,~-,...n'\<~~. l";;~..,{t-.... c~ ~. t!'() t' t'l ~ n l' i ' : !" ~. tl '\. I L) Goor'f.'; ;\l1't'l;<1 Hlstnnd, Jr. in t~th Gt'ade Helcr: Lynn llista.nd in ?nd Gr~~de ~ 'J \ :' \,.:1 ... . " ..... ~.. . " .."." " v.. ....... . . . L02G85 filED ^NO RECOROEO I~ - -OHlcULr~(1lrd 000K , ISOl FES -8 PH I: 13 RO~[R PO},rl.~AS,.(~lf~;<) ( Sl.lUCI( CO\.;;li1. flUf<.IO'o.f&{(L{i r:') -0. t. v 'f" (. -' .0 I . , ,. ..., .. -, , v .. " : ") I fURTHER (UHlfY lh~! I w.ll fe-g'Ile! "t '!)y IIX,)I d-ddrCH wh€rt the fl.-<J:\Hdl.On bo::)ol.., r!.'Open, Ilf\d i:omply wilh ~II O'he-f r{.qUlfc.rnenl\ of a 1~\J~1 'e\!J~nt of !hl$ 5t~li;! I fURTHElI CERl!fY !ha' I h,ve r.() lnlenl.on to return 10 my fo,me' doml(d~, Ilnd ! ,nlend to rem";,, In Fort Pierce ~Jt. 1.ucid Covnti. FlorIda, ~~t",} [~rmllf)ent!'1 4u~.~~ ~< , ~....vcj.yn G. li i stDnd (1\4<." tK,l ,....., ~. Februnry 19 S'h~!\ 10 and $!Jblu ,l><<l bl,,1i)t41 me tbll 8 .~~ (Jf 1 .' (. /t'~" ';: ~ hOlt!'I' 1'01 t.rilS C 1.P!,'k ' . .,' IJ *1 ',. j ~ h - v , , - v .~ 1 '4,)l It'.' f QOGER POitRAS, ClERK CIRCUIT COURT .:JJ'!: r : . ',: \". r /J ( ~ 'J. ,1/1 i ~: '" It ,',. 1; . ~ c....~; l7'~.."'(<-.A(. O.c~ "';. 't"'i 1tt',ifY,~ir::..t'(l a~plt~i - _r' _. .~' .1 po \~T;.-I '"Jot ~* ...M....... ""......._......4...~ t&.f~,t..t"t;:.u~:'~".';'" .t.r-e>-. ..i4 T.. .-1 . ' " " l v ...' ," ~ (:' ,l' \ " ~1(IIMl Publl( B, .,...S- ,J " .. c ...:;. << 62