HomeMy WebLinkAbout1357 I ration of Domicile end CitiZenshi
Dec a p
F
. }
t
TO Tlilr CLERK OF THE CIRCUIT COURT. 4a'~' e 8
3w• in t Lu p i e COUNTY. FLORIDA: s
Thb b nAy declaration of Domicile and GYtbeaship is the State of )Florida that I am Glir?g fhb day in accordance. and in
eoatoranity with Section 222.17. Florida Statutes.
1 was torarerb a kgal resident et - ~ I
IGt71 18c•t~1
resided at ~ - . However. I Gave changed my domicile to
ISenrt aid N~bsr1 r
and am and have been a bona tide resident othee State et Florida since F.hue r~r _ ] Qhl -day of
~ 1~_bl._.. and I reside at ~Q1 w a n d w r A t!w
18trwt sad Noebr)
Fort Pi er a _ Ss i_nt h ~ c' a County. Florida.
IQ41
and t6b statemegt b to be takes as my declaration of eitiaeaship, actual kgal residence and domid'le in the State et Florida.
. ~ ~:~CUR~EO
.
'79 ' ~ 3 i, Pi~1 2 : 2 0
.432.328
I FURTHER CERTIFY that I w~71 regi4ter at my local address when the registration books reopen, sad comply with all
other requirements of a legal resident of this State.
i
I FiIRTHER CERTIFY that I have no iateation to return to my former donnic~7e, and I intend to remain in
Fnrt ' Pi Prrw + _ SI i _uri a ,County.
layl
Fbrida. permanently.
t nom e -
K.Cre~orv Kimbriel
(Nam.)
5001 Oleander Avenue
n tAedrwl
Sworn to and subsrn'bed before me this 29th day of
' January A.D. I9 79 -
s~3 ' 0.L
Notary PaWit &att d FleeWa at Iwrp ' . „
. -
~ . ~.1 . v
My Commission aspires Au~ast 30. 1979- . ~ ~ ~ ~
~2 ~ f~M+~~ 135? , . x ~ L~:~=.. _ - .
BGG!(
1 AGO Form 71 22
z - ~ - - - - - - - ~ - i