HomeMy WebLinkAbout1793 .t „ . ~1t~ . /
~~~~~i1f ~~.`VJ i ~Oi!?lViiv ~.:i Li~JJ ~I~.~t~Vi ~V~ 1~~ t
•ro •r~~i. s~r;~~l'G A\1) (•ouN~r~~ ~r,~x nssi:ssoit, ' 2362'~'5 ~ I
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~~td~1..~.` T _cou~•rY, i~l.oiti»n:
11~is is my ~Ircl;iration of t)c~micifc ancl C'itii~•nsl~ip in th~~ Stat. of florida that I am filinc ihis day in
accardanrr, :ind in ~:onformity ~vith Scction 2''2.17, Florida Statutrs. `
I was tormcrly a I~ral resid~nt of (~l.Y.k_11~ ~ 71:~ ~ , and 1
(citr) ( tate)
residcd at ~ . I~o~vc~~~r, I havc cli~nged my domicile to
(Strctl d KumMr) ~
and am and have bccn a bona tidc n•sid~nt of thc State of rlorida since 2~~' day of
. 1
T, 19~~., and I residc at _R2 ; _
($lteel and Number)
~ ; _ ~L-~ i ~L t ~ County, Florida,
,
(c~V') .
and this slatement is to be taken as my declaration of citizensliip, actual legal residence and domicile in the State
of Florida.
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(Inxri here any {+ertineot facls, such u sale of praperty cx business, or relinquishment of employment at formet
domicile~ removal of family ~o new domicite, purchue ot home, c~c.)
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~ F11E0 AN~ 11EC~RI~EO C
ST.IUC~E CJUN Y
ROCEA POlTRAS
- CIERK Ct~.CU~T COURT ~
' ~ RFCnR3 YE~~~~EO~.,.-
- - ~ a~ ze ~0 34 aH ~1Z
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! FURT}iER CF1tTtT'Y tl~at i~~•ill register at my local address when the rcgistration books reopen, and
comply with all otl~er requirements of a leg:~i resident of this State.
I FURTHER CERTti'Y th?at I ha~e no intention to rcturn to my tormer doniicile, and I intend to remain in
~ r~ ~
~lll ~ •'L'. (
~ t .~1_t t_!' e , • -~1~_ r ~c[i' L~ , County,
Florida, pcrmancntly: (~'`r) •
HRS. DEBBIE BIXLER
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w. ,,,~~u1~u~?~n,, • " . ~
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~ r,v~T (Name) -
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~ ~ ~ ~ ~ i. % ~ . (Addtes ) ~-j'y5~
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S~im~ o a~id s~~b~cn~c~J $cforc mc this L~ day of
v ey
: . a.u. i ~_2 .
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My Commission rrpirrs .
(Tu Ix cieculrJ ia duplica~r anJ uuKi~ul fdrJ ~~iU~ l7~•~k Ci~cuil (ourt. anJ JuplMalr wilh Taa Aaarswr)
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