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HomeMy WebLinkAbout2004 ~ • ~ • • ~ • ~ • _ • n(~ +e~ f~.a~~~/ . V ~ ~~:~Y k6~i~V Cv~ lil.~[~~~ i ii!./ ~rc~ ~ ~tti~ ti~i~.~, ,~~i~ c~ut,~~i ~i:~~ ,~~~i ~~c~it. i~3644~ ~ ~ ` ('c)ll\ I~1'. I l.c~l:ll):1: 'i~hi~ is n~~° ~Irctaratiun c~f I~~nniril~• :~n~l ('~ti%Ln.hi~~ in thr Sta1, c,l' I~Ic?ricla tlr~t I am filin;, lhis ~lay in i :~c~orz?;utc•~•.:ui~l iii ~u~il~~~rmity ~~~ith Sr~tic~i~ I~loriila Stalut~s. ~ ~ ~ ~ 1~vas fanurrly a Ir,~al rrai~l. nt c~ I~ - - /Z~~~ and 1 (Cit~ (stacc) rr~iclr~l at --~~~1.___---~ ~c;~Ll1~----- .}lo~~~c<<r, 1 hu~~c changcd my domicilc to ~tittrrt anJ I~un~tx•r) and am ~nd ha~•r b~•rn a hona tidr r~sicl.nt uf thc Statc Uf l~lorida sincc day of ~~C , 1 anct 1 rc~idr at _L~7 ~ ~ (Strerl anJ humtrct) ~i , Cowriy, Florida, cit ( ) and this siat~mcnt is ta be lakrn as my drelaration of citizenship, aclual le~al residenee and don~icile in the State of Florida. (Insrri herr any p.rtin.nt facts, such as salr of proprrt~~ t.r businrss, ur relinquichment of employment al formet dumitJe, retno~al uf family to new domicilr, purchasr of hume, rtcJ 9 ~ ~ . A- ~ ~G 4 / L/ ~ 4 ~ ~ ~ - ) - ~ ~ ~ o~~~ ~ ~r ~ L- i ~ ~ \ • , ~ ~ -'f-- -o~.~~~~-`~~~- _ ~ ~ ; fIl.EO ANfl RECOROEO i SL LIICIF COUNTY flA. ! R06f f F~!TR~S ~ CLEP.K C:::GJIT COURT ~ RFCQR'1 YE-.~r EC.~„~.~ . a~ z~ ~ ~ 52 ~M ~7z 23644 ; . 1 fURTHt:R Cf:RTlf=l' th:~t I~~-ill re~~ister at my loral address ~~-hrn thc rcgistration Uoof:s rcopcn, and comply ~+~ith all oth~r requirement~ of a le~al rrsid~nt of thit State. I rURTlII:R CI~ IFY tt~at 1 harc no intcntion to r~turn to my tormer domicilc, and 1 intcnd to rcmain in • - - : ~ ' , .C~%I • ~.~r-LCc%c~ , County, florida, p~rmancntty: (c~~r? m MRS. . I,. Yl LE~T ~ ' ~ , ~ ^ . '~,~~i ~ ~p• (name) ~ ~ ~ G : K ~ ~ . . ~ • . ! ~ ~ ~ : ~ ~ ~ .~../~'G : .~L! _ ~ _ ' ~ . 1 ~ ~ ~ ~ (Addre~s) _ y : . . ~ . " ~ ~~u.~. , ~--P. . ~3 y ~ds~t tu and sub~~il~rd h: fc~r. mc thi; - day of , . . . ~ . - ~ A.1). 19 ~ ~ - -C~~- ~ - ! ~ _ _ - o . o~x~05 ~~-2004 I~1~~ ('c?mmi~.,ion r~~,irr: _ - - (Tu h~• cucuti•d ~n du~d~..~ta• ~uJ un~ in.~l (drd ~~~~I~ l lrrl ('n~'u~l ('outl. anJ dupbc:~lr ~~~11~ 7ra A~~r~+n~) ~ ~ ~ ~ - - - ` " ~ j _ s ~ . _ , . . _ . , _ _ . . . r*._...'~"~~"~