HomeMy WebLinkAbout2009 O~a1ua~ ot Oomlau~ a~l Citl~~nslNp
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To tf+t sr~~ ~ couNnr r~?~c ~ssESSO~. ~
s~. tua~ couNnr, aorti~?: ~ .
This i: my d~duation of Oomicil~ and Gti~nship i.~ tM Stat~ of Florida that 1 un fili~p thls day in aoaxdana and
in aonformNy with Chaptsr 4ZZ. Ssttio~ ~2Z.17. Florid~ Statula.
1 wac tormKly a tpal hsid~nt o~t w~n~ IIId
Ki1y) (&at!)
and I nsid~d at 51y CoIIStBtIIC• Avs. _ ~w ~r~ ~~~a
• (SNNt and NtMr~b~~) -
t~ ~nd am snd haw bMn a bona fid~ ~id~++t of 1M Stai~ of Fbrida dno~ 28th
auiT , 19~Q, ~ Ht 3 eas 505 8 Qran~ce Ave Szt
tSt?~t and NumbK?
1'ORT N~, SAINT LNCIE tOWiTY. !'t~ORqA - -
and this statam~nt is to !~e takM a: my dsda~~tion of ati~hip, actual Ipal residena and domidl~ in fhe Stat~ af Horida.
p~sert hsre sny pertinent fac~s, urch as sale of propKty or busin~ss, or nllnquishm~nt of ~mploym~nt
at former domidl~, re~r~oval of family to new domicil~. Pu~cha~ of horr~. Mc.) .
$atering Oindy in the 2nd grade
. ~Q ANO~ RHCOR p~ -
~ ST. l,U~l! ~OU~'f Y,~,'~ . .
- ~ R~C4RD VERIFIED ` -
~10 ~ ~~~'?~?1~ -
AUG 28 PM t2 ~ 3!
~ ROGER POITRA~
_ ~LERK CtRCUtT COURT~ .
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4 I FURTHER GERTiFY that 1 will aomply with dl othK nqutn~rMnb of a ipd ~id~t of this Stat~.
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~ 1 FtlRTHER CERTIFY that 1 have no intention to rotum to my former domic3l~, and 1 inter~d to r~main in FOiCT
~ PIEiKE, SAINi~_WGE COUNTY, FLORIDA, permansr~tly.
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_f ~ ~ bed befor• ms this 28th ~ ~ ~ug~et ~ 19 70
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~ C~GMT CAtIRT ~ Notary Publk.
°a"`-~i'L ~ O.C. My Commlasion sxpins
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