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Dec~arat~on of Dom~c~ie end C~tizer~ship t
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To~cz.Exlc oFTi~ECIRC'UITOOUAT.
S' 1" ~~JG/E oovnrrx. FLOitIDA:
This is my declaration of Domidk and Citisenabip is tbs State of Florida that i am tiling this day ie aooo~+daace. and is
ooafonaity with Section 222.17. Florida &atutes. _
I was tocaaery a legal resident ot• L' ~ V
~~r0 d ~ ~ _ +ad 1
ICtyl ~ ISwd
resided at ~t~ ~ A!~ /y~l-'
~ :.~1~ _ Harerae. l bave ebangsd eay domieIM to
18tswt a~ rl..~e.rt
and am and haw been a bow tide resident of the State of >!'beida siaos ~ .T __~~6.di.~ day d
~ ~ ,18.x, aadI reside at 2 C ? ~ifl.~, ,~~'U~so,y ~ r
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Poser sr, ~ s~ ~ ii iF'~'
ceuaaty. Florida.
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aad this statement is to bs taken as trey declaration of citheaship. actual legal t+aideace sad dowieile Ia tbs 8tats of Florida. ~
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I FUIiTHEB CERTIFY that I rvlll register at my local address when the registration books reopen, sad comply with aD
other requirements of a icgal resident of this State.
I F'Lf~TOK / - .3 tL UG w ~~ntion to return to my for~~on~icde. sad I intend to remain in
E' j - L U G ~ ~ _ County.
llxcy)
Florida, permanently.
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INS.
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Sworn to and subscribed before me this Z D ~ day of
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,~.~yA%~'~~~i:s;~j rjalatj PYslie SLRti Fl~xida ~t Vljf
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,~s NOTARY PUBLIC STATE Of flOR1011 AT LARGE
~~~irly Comnihts7on'4;cpirea . ~tX~LIMlILS~ c:PARES ocTOBEg 1. t9~3
; k r. Y'; . _ IItSIIREO YY FIRST FINANCIAL ADVISORS
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