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r'o>~ T. v-~~^i-D-~6u~c-3-~~s-a^r; ~~29 ST ~UCIE COUMTYRFtA. ~ ROCER POITRAB - D@C~Q1'O"~I~l'1 t.~OR1lc,~~~ C~!"1~ ,~iti~£RS~i}7 RECORD VERt~f EO COURT TO T~i~ STA•rE covt~r~' T;~h. .'.~:SE~Sf.1iZ. Arlt Il II 44 AN'71 ~ T lJG COi.i2~'T7i, FLORIDA: - '~~1~ Thi~ is my ~eclaraticn of Domicile and Cit;~e;~ship in the State of F:orida that I am fi':ing thia day in accordance, and i~ conf~rmity v~ith Chap:~~~ ::22, ~ection 222.I7, Florida Statutes. 1 i aas form}~r~l a leg~.l residenL c~f--- _~~Q~F~~ K_.--------- , ~.11.R~ !1_?_1_ - t C:ty) ( Ststei ~nd I re~sde~ st .~T~S._ ~R!~'1_ELEG_~ . CiRGt E.___i9.P T_!__~L3 However. I h:~ve cnanged m~ dar~icile f ~ :.-.^c: ate3 ':u;n~er r to an~ am ~~:~.i ::=:e~ ~~x:r~a ;icf~ res=:ier•t oi the a.*zie of F•?o;id~ since------------- day oi ' ' ' ~ ~ ~Q.l'~ ~ 90 ~ ~ - a:]II i r23,u8 fs`L.°------ - . . _ ~ (St:eet srd iJi:m~rt) Fo~~--- --p/ERC~ - -`~`-7-'----'~51~1,~---------~-- --------.^.~unc~•, Floridu. , . r_::. =i~a.`.1 L~'319 8:3tc^•IY'3~`.T 18 . ,•s': L:: ~°_T~ y:L~t' . i!i Clt1Zr?:iz:-~'i~ .':.L`:~:~1 :~'~b~ ,..:F:i:.^-T:TL' 'n:',fi fl!%7!3)C:~@ i2'. E ~Tai~~ ~ ~ ~.•,`i'lf.i~s. (li18QY: %1~:: . t^~ ,:Sli: [3:~.~~ 2'IC~• r•- „:E 3~."[7tf OT i.U:.i~•rr,, ~r r~:iuqvisbrF~:t c+:~ .rrr.;~ia=-4s¢nt 3'it +.._rraer i: ~ . . .o± ~a:._ ~ : . . . ~^.-~haEE . .:ma. ~tic.) ' ~t a„n. U • s • ` a~ ~ ~ ~ite~.e..-•~ , ' ' ` ' ~ j .~n. %e~ /Y~ , /`~~a.~. ~ c.,~x ~ u . v y.,~ D~~ ' ~ ?1'11~+~ G~1-d G1~.. ~ ° ~ IL.P,v-cdP~ GtI'L~- tfi . ~ 'iG;'v`~ i . - ` , _ +~`~'.~j ~ ~ j ~ . ~ s ~ F.~.'~.~~ . n ~ ~%~.cti.1 , d~ ~ c3't,u~-r. ~ , , , ~ v,~~~, . . ^~~r,lps, ~ - a . ~~r.~ : ~ ~r.. -~.~s ':~;.en ;tc 'ti•,-•::;cr. ~ai~s reopen ~ y ' a ~.~C:.~i_7.. :i~ _i~ie a~taat:_'. ~ 1 i' T d - ' ' . T ~ _ r . . . : . . _ . . :14 :iG .,;r:..:f.1G.~ t.~ .~3' {017T:C? flfi7dla,_i£•, a;,;; j :nien~ ' . - . t,~ rema:n. __:~D_ieT_.~iEKCF' _ S uC ~ _ . _~~~ty, ~~;a8, - - - ~ - 1 ~ ~:~~r.e:~tly. ~I, ~~U «'.___r_-..__~` __.l~~~ f i~:a~?t s~yg- ~ { , . ~ - ----~---u~-~~ . x, c~a~ ~:ri to ar:c1 suhs..rib~;I t~f~re ~e ~l;;s_~•3.._ d~,;- =:i ~O'~'~ ?~~~a,~ 4~,~~',i - . ` ~ _ ~ _ r~ • • • ~ ~ ' ~ Af/~" - ~ } ~ ~ ~ : ----Notary-- ~t "Sta~: af ---e - - „ = Y• , i ~ . C~,e ~ , ' , - r-- . a G, , : Comm~ssior. e.xpir~s.. --.._.L9 73 - _ - _ . , .t~ - ~o . ":'o ~ exec r 3upiica's a^3 origiru.l 61_rd ritc ~;e:k Circuft G;art, sn~ daF?.i.-ate Rrii~"'l~~i[ As~NSOr) $ ~~Ui ~~~'1'~ 3'"~'~`.~'3, a' ;.f._.~ s-. _ -::4 .t.. ` n _ .