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HomeMy WebLinkAbout4678 D~claration of Domicile and Citizenship ~ ~'~19 ~fU T}It~. S; ~i: A\t) ('OU\Tl' l A\ ASSI SSOIt. `~'1 ~ «Gc~' ('Ol'\"I~l'. 1=LOR1l):~: 'Thi, is m~~ clcrlar.iU~,n uf l)umirilr an~l ('iUrrn:hi~i in th~ Statr ~~i l~luri~ia th:it I am tiling this ~1ay io a~coraan~~. ai~~l in runti~nnit>' ~vith Srrti~~n '__'.17. t=luri~la S~tu ~~vw~ Qt~a-/Y xsr+wF I was t~ornirrl>~ a Ir~.:al r~sidri~t ~~t Z' " ~ . - _ - - - _ and l rc~~~ ~ - - - - ~s~~<<~ r~.i~l«i at Z-1 ~~rrN'~~ ~'t` - Ho~vr~•rr. I ha~•~ chang~d my domicil~ to (ti4rrrt and Kumhrr) and am cin~1 ha~~• hr~n a 1~ona ii~l~ r~,iclrnt ot thr St:it< <~f 1=lcirida sinre _._:~___1~-- day ol ~ ~ ~ S 10~.1'-- f-- - ~ . ~ 7~ : .,n~i ~ ~r.;d~ .,t / ' - ; (Strrrl and Numlxr) G~~ C~''~~'~ - - _ - _ Co~mty. Florida. _ . - ? ;uid this,t~t~m~nt i; to h~ tak~n as my drelar:ttion ofrilirrnshi~i, artual l~gal residenc~: :~nd domicile in the State ut~ Florida. • (Inur. hrrr an~ p~•ninrnt (acl,..uch vlr uf pn~prrt~ a•• ti~~<inrcc, ur rcl~nyui~hmrnt uf rmpiuym~nt at furmrr dumir~lr. rrmu~ai uf f~nuh~ t~~ nr~~ dumicik, pur.ha.r of humr. rt..) . ~ ~ ~ ~'v~'' - t~~ C-~-C / ~-tc~~lt t~%Lp i ~ ~ G~ - , f f1LED ANO RECOR Ed ST. IUCtE COUMTY ~l~ RQCEA POIti~~= ClE1tK CtitC~~T COtMt IIECOPO vERif1E0.~---_ ~ i ti ~l Mi'13 i . ~ _ € i ~ s 3 ~ ~ ~ :z ~ m ~ ~ ~ ~ I t=UKl til:tt (~FkTll~l" th:?t I~~~ill r~~_i,t<< :+t m~ !<n:+l a~ldr~ss ~+h~n the r<<~i;trati~~n hook, reo~~rn. ~nd ~ ~~~iit~,ly ~~ith ali c~th.r r,•~~uir~tn~nt, ~•f:i 1:,~:i1 r~;i~lent c~t thi. Statc. ~ I t=l'RTHI~.R (~I:RTIFI~' tl~:+t i l~at~ ~~u intt•~l[i~,n tc~ rrturn [u m}' t~~rm.r clumi~ile. .ln~1 I intrnd t~, r;n~nin in ~ / - L . ~G.~Gc.~ (~ount~ . ~ c~4'• ~.~-~1. -GG f . ~i - . - - - - - ~ , Fluri~t,~. F~~rni.~n~~nti~. ; ~ ' 1/ ~ • ` • 3 ' ~ .~.i`( / tL ~ ti - 1 •I ~ I'V ' /Y " /~-sC1? .~'e4~~ - l:\Jdrr.tl i` = ' 5~~~~rn .in~1 .uh:~rih:~1 hrt~,r~ ni~~ tl~i~ u,i~ , ti;3 ; . ,-~.t). T 3 - .~~i~'~, G~~ri' . ~ .L c.~c.2--t_. . ~ _ - ~,~y'' ~ ~ ~ ¢-C ~L2~ ~ " ~ ( ' r'. ; ti„~,~. r~~h?~~ 5c~~r;~Fi aJ:~.~~ y~:...~ . _ i_ : ~ . ;(:?J~.s;'oi L't[G . , J ' O ~ ! ,~~LEG '.n4~~ s; . . . . ti;~ • . ~ ti1t~ ('onttni.>iun r~~~ir~~, - . ~ 4 Jj-- ~ v . , ~ J ~ ; . _ 1!~~ hr r~c•.ulc.1 ~n d~i~•Yi..~tr .~nd ~~n:~~+.~1 t~i ,t •..~11~ 1 irr1. <'~nuit Cuuffl~~q~~l~~ht•.itr .vth T~~ A.K•ti~rr1 Q ~ 20~ 1~' ~ ~ - ~ . T_ ~ - : _ ~ ~