HomeMy WebLinkAbout0816 tion of Domicile and ~itizenshi
Declara p
4'71606
TO THE OF E CIRCUIT COURT.
' COUNTY. FLORIDA: .
This is my declaration of Domiet7e and Citizenship in the State of Fk?rida that I am filing this day in accordance. and in
conformity with Section 222.17. Florida Statutes.
I was formerly a legal resident of _ ~j. I
iCSty) l8tato)
resided at _ _ _ However. I have changed ~ domicile to '
i3tre~t sad Nu~mbae)
and am and have been a bona Ede resident of the State d Florida since (.i'1 Q 20 r1~1 day d
19~ and I reside at ~ ~ ~ 1!_~Aar
~ Q e e
t8teMt zed Numbs)
~ R. County. Florida.
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and this statement is to be taken as my decoration of citizenship. actual legal residence and domkl7e in the State ai Florida.
S'
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~ JAN -4 PN 4: t 2
F LEO AMO AECORCtO
S~ LUCIE COIMTY.FLLA.
ROGER POITRAS
CLERK CIRCIHt COU T
ittCORO NERIffER____~.~~_
4~71sos
I FURTHER CERTIFY that I wtll register at my loeil address when the stgistration books reopen, and comply with all
other uirements of a k resident of this State.
i fey By .
R
~ I FUR R CERTIFY that I have no intentlOn to return to Amy f~r domicile. and I intend to remain in
f '~Q rl~'o - ~[:f~ 1L¦ CI Q -County.
lC5ty1
F
E Florida. rmanentl
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E
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i. i.lC ~
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r I~.li
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G. o ~
_ • i ' min i ~ !Y'L
F Sworn to and subscn'bed before me this ~ day of
f
t p~
i' A.D.19 Q ~
i 1
Lnae~tiJ
Stet. d h7orida a
. nsu aa~~
My Commission aspires - - ~1AN1>!~ ~ SNI Mi1~AJ
11MtIC StAIE Oi RORI~ At I/VS+t lg~t 1['T~M1 S~IIIA NOISSIMIM~ 4A
rr o~w+sssla'' ~ut~s n ~,ras it Mono so ltvit ~t~r?+ 1rillA~+
~ . 1~
o~e:ecuted is duplicate and oriaiaal Aed with Clerk (Sreuk Court. and duplieata with Ts: A»esaorl