HomeMy WebLinkAbout0121Declaration of Domicile and Citizenship
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TO THE CLERK OF THE CIRCUIT COURT..
~-~•~~ COUNTY. FLORIDA:
ThL L my dselaratiou of Doanidle and Citiaeuship !n the State at Fbelds that I am t0ing this dq ~ accordance. and in
oontoraaity with 8ectiou 228.17. Florida 3tstutes.
I was formerly a legal resident of ~ _ _ _~mZi -.~..~_ and I
lCit~) tatty)
resided at 1~,~y~~iCs..~~t c ~ ~~
(street sad Number) I haw changed eqy domicils to
and am and haw been a bona Sde resident of the State apt Fbrida since ~- Q ~ d•r ~
I~' ~'i`'^ d •
,19 and I reside at
(Street and Number)
~~` ~ n;= County. Florida.
(atyl
and this statement is to be taken a. nq declaration of citizenship. actual legal residence std domidle in the State at I~7oeida.
~~ ~~ ~ ~ ~7
~R
Rlgafta t'ERIf1E0 ~ _
508880
I FURTHER CERTIFY that I register a~my local address when the registration bode reopen. and comply with sU
other requirements of a legal resident of this State. -
flat I have no intention to return to my t r dom~i~ile. and I intend to remain in
c.C~ct @Q `t ~-• s ~ -County.
(Cdr)
Florida. permanently.
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~8wote~o~ subsen"bed before me this _.,~_, day of
A.D.19 V
tart' State of FtaWa at
My Commission aspires
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a -e ~~
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atOi~r w~uc st~~ a t~aua M ~ u
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ITe he ~eteted i sad aidiael sled erki CMek drndt Caen. sad drptiate wfti Taa Aeeeeeerl
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