HomeMy WebLinkAbout1734 ~t?~: ~~'c-~~E^~ Gi Q: i
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------C'UUU'I~Y, I~LUltil)~1:
11~is is my ~Ircl:ir:~tion c~f 1)c~micilr .inJ Citiirnshi{~ in thr Stat.• of ~lorida that 1 am filing this day in
accard,incr, aiid in canformity ~vith Scclioi~ 2'_'3.17, f~lorida Statutrs. `
1 was formcrly a Irgal residrnt of ~ ` and 1
cc~~y~ ,1~1- cs~~«,
residcd at .~v ` ~ lf~o~vcvcr, I havc changcd my domicitc to
(Sirerl aod KumMr)
and am and .havc bcrn a bana Cdc resicicnt of thc State of rlorida since ~ day of
~l
, 19 and 1 residc at ~~~T~~'R f`/AiD
~ . ~ (Strect and Numbcr)
~~~~~.IQ C _ l p~ , C~V ~ County, Florida,
(a~y)
and this statement is to be taken as my declaration of citizensl~ip, actual 1~•gal residence and domicile in the State
of Florida. ~
.
(Inseri here any pertinrnt facts, sueh u sale af property cx buciucss, or retinquishment ot employment al tormer
domicile. temoval of family to ne~v dumicilr. purchase of Aome, clt.)
-
SHARI ANN CAPACCIO age 8 •
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1 FURT}IER CE}tTIT=Y tl~at I~vill re~ister at my local address whc•n the registration books reopcn, and ~
comply with all other requiremcnts o~a Icral resident of this St~te.
t FURTIiER CERTIF'Y tl~at t ha~e no intcntion to rcturn to my tormer domicile, and I intend to remain in
~~r . '
~ b Ld vG/~ , County,
Florida c ~a~tic~lly: (c~~r) G)
~ RALPH CAPACCIO y~j ~ ,r
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~lLvt1 brforc mc this day of 1
~ ~
'~~~~/Ifl? 11 ~ • ' 3
A.D. 19 ~ - ~
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My Commic~ion rx~~ires_ ~ ~
(Tu br c~rcutcJ in duplicalr anJ o~i~ in~l f~6•J ~~i1h Clrrk fir~uil C'ou~t. anJ Jupla a1e w•ilh Taa AtasaM)
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