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HomeMy WebLinkAbout4669 Declaration of Domicile and Citizenship TU THt- STATI: Atil) ('UUN7'Y 'I~r1X r1SSt SSU}Z, ~r ~`~~~~Q ~-C - ~ t't)t;\Tl'. ('i.ORii):1: - ~i~hi. i, tn)~ ~trclar:cti~~n ,>1 llc~ms~il~~ .u~il ('itii~~i~,hi~~ i~i thr St:~t~ ~~t f~lorida ihat l aqt tiling this ilay~ in arcur~i.~ncr. ami in conf~unnitv with Srctic~n "'.17, t=lc~rid;~ Statut~s. 1~~~a~ i~ornu rty a Ic!~al rrsidc nt ot~ ~ t T! C`~-~ - - . and 1 fc'ie. ? (St~te) r~si~1«I at (i'! ~ L~.~ t~ ~ f~~ ~ Fi . I/l~(ZCc~ Ho~t~ev~r. 1 have rh:~ngr~! n~y ~lomicile to (Str.~t ~nd umh r) 1 an~i arii ;u~d ir~vc hrrn a bc~r.a tic1~ rrsiJ~~~t c~l thr Statr of F~lorida sinc~~ -~~t da~~ oi a1 V_ ~ 1~) ~~.:~n~l I rr,id~ at v L.~4~~ _~Q1!!~ - - - - - - - (Strrrt •rnd Numberj ~ ' e r - ~ t r . C C G E _ - . ~!r_ _L t!_~ 1_-t~- - - County. Florid:~, (ci~> ? and this statentrnt is to be tak~n as my d~rl,~ration ~~t'ritizrnshi{~, artu;~l Icga) residcnce and domicile in the State ut' Florida. (insrr. Arr. ~~n> ~rrtinrnt faa~~, such as ,:~Ir u( pruprrh or husin~ss. ur rrlinyuishmrnt of rmpluyment at formtr d~:.^.icelr. rcmu~al uf fa~mly tu nr~~ du~aiclle. purch-rsr uf humr. ~tc.) I` w ~Y~ ,/~w _ ~.~-~-v-~ ..i-1- ~ t7 , ,p At~~-. ~l~ ~n - ~ ~ . ~ / J~ n V ' ~ ~ ~1M4 ~ ~~E t ~OMTt~~fu. aoc~R rortus ~ ~ CtE~II C~t~CtqT COi1RT _ . ~ECOtIO vER~~~f~...~..,,¦.,. ~Mr 1 1~ ~ 11~ `I3 ~~~~~7~to I f~URTHI-It (~t-:R"~1FY th.it I~rill rc~~~i~t~r at m~ ic~~al :~~l~insa ~~~h~n thc r~,~i,tr:~tion hooks r~o~~en, and ~~,m4~1~ H~ith aU ~~[it~r r«~iiir~tn~nt~ ~~f .i lr~:ii r~,ici~nt ot~ this Stat~_ ` I 1=l~RTHI=R ('t~RT(t~l' tt~at ( h:i~~ n~~ i~~t~ntic~n tc~ r~t~cr~i t(3 ITl)' (Ot'tll~f (~OIITICIIC_ ~711J I I11Iit]CI t0 fcl!]ain it~ ~ ~t . ~~C2 C z . S Lvc~ E' . c~,~~„t~~. l=1~,rul:s. ~>:•rr,:a~tc•titl~ . ~c ? ~/c~ - _ . , - ~ ~ : itiam~) - • O ,y~~: r" 7S 1 ~ti . ~ ' ~ ~ ! ` ~1.,• ; ' ~ ~:~dd?~•..? , : - _ : ~ ~ ~-P~- S~rc~rr{-'~~.~~c~~Citf~```r~«1 h~•t~~>r: th~. ~ ~~t~ , t~'•.~-- -r r,c~~C` - :~.1). I')'~ ' ~ ~ ';~1-~":: • . . . , ,,~/~j~` , j ~ ' , - C 7ll-{ C % ' :1~niar~ f:~ ~ Siata ~~f f f~iriJa +t l nr_~ ~ ~ . ~ _ J~ EC~~r (..V~~ 'rA~~t ~~~~r ~1} (~c?rt~mi~sion e~E~ir~~ , ITo h. t~r.utrd m.lu~~h~ ~t,• ~n.t ~~rn mnI tdr~1 ~~~~h IlrtA l~t.ud (~nut. ~nd Juplnalr ~~~th Tr? Ac,r~.ur1 - rr-, - - - ;i