HomeMy WebLinkAbout0235
Declorat~on o~ micile end Citizenship
TO THE STATE AND COUNTY TAB ASSE$8OR,
as. ~vcas oovNTY, Fi,oau~A:
This is my decLsatton of Domicile and Citi:anahip in the state of Florida that I am ~ this day in
socordanoe, and in conformity with Chapter 452. Section 222.17, Florida Statutes.
I was tc~erlp a legal resident oi~.fieh_~1aai_-_-- ~_____ !'lOrida __..____~
and I :+esided at_-------3~-->~ .~ St-~__... -----------------------. However, I have changed my domiciie
(&r«c and Nasrb~)
to and am and have been a uo~ ~iu6 a:.tvf tlts 3tAto of Florida since----------- ---- - -- -- - - - - ---~. ~; ^f
Ja[1 N~1M_, _ . 19~. sad I reside at ~ ~ Ha~~b..~..._~t~2 ~Qr~-____-~_..
i~iee.s and :~iu.~us.i
Bt~~gie rr~.,rfv
.~.F~~ orQa _. - _ ---____-.___---- ---- -~. ~'~.
(City)
sand this statement is to be taken as my declaration of citizenship, actual legal residence and domidle in
the State of Florida. '
for doaidl~i. ~ ~~ ~ domlefla. vai'~ a~ 1•~i~e~nLL~t o[ emDlo7n~+~at at
--- - -.Y, V.r...~.-... ~~r en ~-~sa~fQ
X17 DiBA w ~~aAi Vt siava~ar.~i s ~ii- w. ~ r..:. ~ - = - ~-
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F'L~~' ""~ ~'E ED
Ip ~. n~l
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S~. IUCIE COUt:TIf, FLOh~~A ~~
and ~ w~-it~aU other requiresnenb of a legal are id~ent o~ t>bia ~tewhen the re2tstratioa books reopen,
~~n~s~n r+~Q+ns~v slat j L.v~ ~± i*t43ein ~ tQ ml/ termer doaiicx~. and I i3ntt~ t4 reaiaiit
~ lort Pi eua • ~ Bt .I:ss i~ _Coant7, Florida.
Y. T. Di~ie~
to and subsor_ Ihed ae~i pis --~,1! ~
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Commi~oa .-
cr. b..~«~aa m a~
s..w e.vrh tx.. Tfa.c cos. r•.
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.ei~al ftei wia a.~ c~ o..eR ..~ igifeat..rita ~ aa~•.•o~l
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