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Declaration of Domicile end Citizenship
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TO THB CLE/RK OF THE CIRCUIT COURT. '
L H~ COVNT7t. FLORIDA: `
This is my declaration of DomieiM aad Citissaship in tM State a[ Fbrida that i am Nina this dy b aooordance. aad io
ooatormity witA Seetioa 222.17. Florida Statutes. - - ,
I eras tormeryr a legal resident at• 7LA.tMi~/6To t s /~/~l.~i s/~/ and i .
ICIVI (8t~es1
resided at Z~.~/s/ ~~.tQ~/. ~s/ yr~ vE - Ho~wewr. I bare ehaog~sd mi? domidle to
lehwt sad Ns~bsrl i
and am and lu?ve been a boos tide resident ottM State at Fbrida sirens -Z ~ ~ ~
.C~aw/E - ~lh~d .andlresidsat /Sol ~~E.P ~o~.ps-
- / / l8hwt sad Nrbrr!
j~E.r~F - _ ~S T L lip i~ Cannt~. Fbdda.
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and this statement is to bs taken as oqr declaration of citisenshlp. actual legal rssidenoe and damidle in the Stats of Fbcida.
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I FURTIiER CERTIFY that I will register d my heal address when the registration boob reopen. and amply with aU
other requirements of a legal resident of this State. - .
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IFURTHER CERTIFY that I have no intention to return to my farmer snd I intend to remain in `
• ' ~t ~r : a~ic .County.
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Fbrida. permanently.
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~ Sw to and subscribed before me thi, day of
- 1998 JU. ? ~ 1M ~ 08
A.D.19~ S 1 R
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