HomeMy WebLinkAbout1409 Declaration of Domicile n ' ' ~
a d Cit~zensh~p
4'70083
TO THE CLERK OF THE CIRCUIT COURT.
_ ~'C-~-~-t~ COUNTY. FLORIDA:
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This is my declaration of Domica'le and Citizenship in the State os Florida that I am filing this day in acoordanoe, and in
conformity with Section 222.17, Florida Statutes. !
I was formerly a kgal resident of _ [~'~~f~c b.L ~ ~ce-' L and I
t(:k~) 1 `
resided at Q 7' ~ 7 . . However. I have changed my domiei7e to
(8treet and Nnmbw) ~ y- ~
and am and have ~been~~a bona fide resident of the State of Florida since ~CiG4~/-CJ! iZ ~y a[
~~~'~~'t' 19
7
y y and I reside at %I G Z ~1 ~~t/`e~,
?x~ • ~~C~f'hc
C'-~ ~ ~~asd Number)
~ County. Florida,
((xhl
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State a~f Florida.
f~ 6~C A~' ~ ! !1E~
t;UCtl ' ' ~ ~ F!
AECa~~
O~c 19'4 z3 P~I'~9
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- 4'70083.
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I FURTHER CERTIFY that I w91 register at my local sddress when the registration books reopen, and comply with all
other requirements of a legal resident of this State.
TIFF .
I FURTHER CER that I have no intention to return to my former domicile. and I intend to remain in
.r s/ CiOUIIty,
Florida, permanently.
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Mama
Sworn to and subscn'bed before me this day of ~
t~Ruk ZAVRTrRR o~ t
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N Pub)ie SeaN.d~7o~ida!i.~ae~ "'a at 1 s-~~ _ ~ '
My Commission expires • ~ G •
- ~ BOrac 322 PEE 1404 ,
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CI'o be executed in dupliuee and original 151ed vitb Q~ t~ourt. and dypliate with Tax Aasesear) .