Jaro Henry Smith, sui juris

Main Street 1422

Costa Mesa, Orange county
California, U.S.A.
Phone: 714!"1"4!#
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(H'S 'S A $U%&'C COMMU)'CA('O) (O A&&
Notice to agent is notice to principals
Notice to principal is notice to agents
Applies to all successors and assigns
All are without excuse
Declaration of Domicil
I, Jaro Henry of the family Smith, a natural man, hereby make this declaration of domicil that I am making for the
purpose of establishing my California domicil in accordance with the California Constitution and laws of the United
States of America, and state as follows
I hereby declare that I ha!e had and maintained the place of my domicil on land of "range county, California #a state
of the Union$, since the year %%%%%%%&
My current home and domicil is on land of Orange county, California (a state of the Union), and within the
home being my place of abode and domicil; and having the following physical location
'ain street ()**
Costa 'esa, California
United States of America
which home I recogni+e and intend to ha!e and maintain as my permanent home and domicil and if I ha!e or obtain
another house or houses in some other state or states of the Union, I hereby declare that the abo!e,described house in
California constitutes my predominant and principal home, and that I intend to continue it permanently as such&
I was formerly domiciled since the year %%%%%%%%, in a home on land of -ern county, California, at
.roadway street /)*
.akersfield, California
United States of America
I ha!e not maintained, during said times, any house outside of California, a state of the Union&
! hereby declare that, pursuant to the foregoing, ! am domiciled on land of Orange county, California and am
not a "resident# of the $tate of California, or a "U%$ person% &urthermore ! declare that ! am 'O( located in,
or resident of, any area that is sub)ect to )urisdiction of the United $tates, but am domiciled on the land of a
state of the Union% *ll unalienable rights of the undersigned are hereby reserved%
0lease note that there are no 1I0 codes and two,letter State abbre!iations in states of the Union& 2hose designate
federal areas and not areas in states of the Union, therefore mail sent to address with those federal designations, will
3"2 reach me& 4ou must send your communications to my domicil location, 56AC274 as printed abo!e&
As section 89* (&: e#*$ of the US0S ;omestic 'ail 'anual declares, 1I0 codes are 3"2 re<uired =Unless re<uired
abo!e, +!, Codes may be omitted from single-piece price &irst-Class Mail (including ,riority Mail), single,piece price 0arcel 0ost, and
pieces bearing a simplified address&>
5xecuted on this %%%%%% day of %%%%%%%%%%%%%, *9()& Signed ___________________________, sui juris.
On land of state of the Union: _____________________________, _______________________ county
)O(A*+ $U%&'C
Subscribed and sworn to before e, a Notary Public, by the abo!e"signed Jaro Henry Smith,
#his ______________ day of _____________________, $%&'
() *O((+SS+ON ,-P+.,S:_______________ ______________________________
3otary 0ublic