HomeMy WebLinkAbout0579 ci ra~ion of Domicile ~nd Citizenshi '
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TO THE C1,ERK OF T1~E CIRCUIT COURT.
S T, t... c~ c i~ CpU~'y~ f'1.ORIDA:
T~b {s my derlsntion ot Domieiie snd Citizenahip in tt~e State ot Florida that I aw 6Uag thl~ dar io aaooedsnee. and In
toatormity ~rith Section 222.17. t lorida Sbtutes. ~
I wu tormerly a kgaJ eesident ot y~ C~O ~ y _ N`"e T'`~ c.~`R o'~' i N9 ~ I
iGij~ i&atd _
~ o~ ~ 7 T N, ,~,i. .`~v x 2 v 9~ Hoaerec. I lu~ve ehanged eny domteile to
19tn~t u+d Num~tl
and am and b~ve bcen a Dona fido tesident ot ths State of F'brida since ~N E ~ 3'Q ° ~r °t
c~~--d r3~ ~ ,19 ~G . and I re~ide at 6 0/~S . Z 3 rt v. s: p. ~3c• x/~.s-z~
lSttNt aad Nwaserl
~o~ T/_~~E,2 ~ E ~ T ~ G~~' CountY. Florids.
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and this statement is ta be talcen as inr declar~tion of eitizetuhlp. attual legal residence ~nd domieile in the Siate ot Florida.
i~p ~~+D REGU~UED
~t. WCiE COUMTr Fle.
AOCEa ~OIiR~t
CI.ERx C1RC111Z COURT
AECOaD YCa1ilE0.....---
MaP 15 3 z7 PN'1~
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~ I FURTtiER CERTIFY that I.ruf register at my loenl address ahen the regisiratioa bcoks ceopen. and eamply with ap
! other requircments ot a legal resid•~n: oi this State.
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` I~[JRTHI~:R CEHTIFY thst I:?ave no intcntion to .retarn to my former domicile. and I intend W rcn~ain in
t . ~a~-.~T- ~~E-~C~ ~ ~S'T tSJc/E _County.
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~ F'lurida, permancntiy.
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~ S a orn to And subscril,ed hefoct m~ tti.4 ~ day of ~`1 ~ ~
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~ ; ; ~ ~ARY PUBUC S7AIE Oi ftORIDA ~f UI~Gf :
~~'y " Yr CpUY.t;s?GN ExP~qES RL•"~3Si 1~. 19)8
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~ ITn be~ executed in duplK ~ta sn~: on~ir J Gbd vith Ctcrk Cfrcuft Couri, uid duplkate w;th Tat A?ses~oi 1
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