HomeMy WebLinkAbout2665 Declaration of Domicile stn itizenship
• 4' ' '9
TO TII>; CLERK OR THE CIRCUIT COURT.
L y G l f covrlTY. FLORIDA:
This is my declaration of Domicils and Citizenship is the State of Florida that I am Cling this day aoeordanee. and to
conformity with Section 222.11. Fbrida Statutes.
I eras formerly a legal resident of ~ ~ I
Igcy1 t&acol
resided at . However. I have changed my domicile to
IStrMI cad Nune•r) / ~ `
and am and have been a bona Cde resident of the State of Florida since ~ ~y ~
- -19~ and I reside at ~~l B ~~i4 nA ~ ~ ~ yF
(St~wt ssd Number) ~ .
T',-~
f ~r~ rL G ~ _ ~r L t~ ~ ~ E count,. FlaTiaa.
tavl
and this statement is to be taken as my declaration of eitisenship. actual legal residence and domicile in the State of Florida. `
Ft~~o ar,o R~eoROE~'
. ~r~~ CCUN?Y; FIA.
442669
'T9 MAY t AM t0 ~ 2 ~
T~.. 4
• CI_~RK C;R.titT ~fiURT
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s
~ I FURTHER CERTIFY that I wiU register at my local address when the registration books reopen, and comply with all
other requirements of a legal resident of this State.
I FU~?Z'HER CERTIFY that I have no intention to return to my~prmer domiale. and I intend to remain in
f ~~s ,fll~/~ C C J T• L c/ c/ F ,County.
IC~t~)
E Florida, permanently.
~ l /
~~.•C4~7 KE SitJS: PLO
~ ~~F ~CURiY . f~~ Name) ~ A .
T d 7t D'f n , iC/1~~/1
sT lAaar...1
Sworn to and subscribed beforo me this ~ day of
~ .
~'o A.D.19 7 ~
d A G
~c.«
e/ WilieSaa of Florida N~L../u
~ ±
My Commission expires -
3rrr .
f ~7 SAC: zss4
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l- . AGO Form 71 22