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. Qeciaration of Damicile and Citizenship -
~rorxE oF cuccurrcov~rr. `3~~3~'~
,
COUNTY. FiARIDA:
T6Is is nqr declaratioa d Domkils aad Citissnship In tLs Stats ot ~'lorfda that I am 8tin~ tLis dy? in aa+oedatia. aad ia ~
eontormit~ w?It6 Seetion 228.17. Flo:ida Statates.
I wraa formerb a legal restdent oi ~ I
_ lCk7) (8t~) ~
resided at - Howsver. I 6ave changed ~ domietk to
(8tiwt ~d N~~rl
and aaa and have been a bona 5de resident af tbe 8tate o[ Floelda ~inos -2,,~-S 1 dq ot
- ~~'-.7" • ~ 19~~ snd L~¦Y~at ~r~, ~ !i ~s~. ~ cLf' ~D~ 4 ~~lP~iw ~l?-sr~c.~
~j~ ~Q- s~~l~~t aaa Na~b~r)
~m~ ~LT • ~~~.u~~ ~ . [.e~. ~~Q Count~. F1o~ida.
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and t6is atatement is W be taken as m~ dselaraLion ot dtitsns6ip. aetual legal reaidenae and domieils in tbe Stata ot Floeida.
I AN CURRENTlY EMPLOYED BY THE U• S. GOVERNMENT AND
AM VORKING AND l1VING IN GERMAHY~ HOVEVfR~ UPON MY
RETIREMENT IN THE NEAR FUTURE~ ( AND MY MIFE SHA~L
8E l1VING PERMENANTLY IN OUR HOME LOCATEO AT THE ABOVE -
ADORESS.
~~h:, ~,k, •G+'i(~
. .~.!?.CIL GG,t;.M~~;1~1,~,
fG~J~.;, :T~
~Ci~~.f~ ' ~~1~!i ti0,~
9f~~~~ yt`::Fi£~
f~x 21 f i ~N '15
- 3193'76 -
I F'UA1'I~R CERTIFY that I w~l register at my loeal address ~v~en tbe reg~tration books reopen, aad oompbr witb aU
ot6er requirements o# a kgal resident of this 3tate.
~ I R CERTIF~~ I ao intention . to nturn to my 1fGZm~9t~
~~e ad I intend to nmain in
~ ~~~Ur~ ~!2~''- ~~~w...~ , ,;/~T - /7/~L~/ . G011nt].
I IC'd~l . - - -
~ Fbrida. permsnently. -
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~ KATHRYN A~Tt~~
~ Sworn to aad subscn'bed befon me this 21 day oi
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i OCTOBER A.D,19 S~n2'S ~P~s
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~ ~ ~ ' ° NIY C~O~AAISSION tX~itES fN. ~ ,~„~~RS
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~ ~~;,,~~,~••~s~r~~,,.•~ ITo b~ eueeuted io dupliat~ aad ae3~in~1 N~d wit6 Cbrk ~ Coort. aed dopliat~ wit6 T~
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~ A~.,O Form 71-22
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