HomeMy WebLinkAbout1249~bo~ 2 663
Declorotion of Domicile and ~itizenships'• ~'~c!E c~uNrr, c~".
TO THE STATE AND COUNTY TAX ASSB,B$OR,
_~ypp,h OOUNTY, FLORIDA:
This is mp declaration of Domicile and Citisenship in the State of Florida that I am !fling this day in
accordance, and in conforauty with Chapter 228, Section 222.14, Flerlda Statutes.
I vas formerly a legs! resident of-_-----~}•~+- ((~q-) -_-_-___________, ._..Xj,p~,pa,a--.-----__-
;--,d Z r~idcd at__-- - 1Cd ~ttls~_~tr~aiL-_.__:_.----------------- ------• However, I have cl-aa_2te~d_ te~~m3~) damfcile
(8tiwt god NnmMz)
to and am and have been a bona dde resident of the State of Florida since-__- 19th -- --- - ---------day ~
-----------$sp~ti---------------------------. 199__, and I reside at-----~t~_~__HQZ__~i1.~1-----------------------------•
• (8treat and Ntusber)
1rt.Pierae, ~___-_-. ----------3~.~~-------------------__County, Florida,
~__-__
-------------------------------------
(cit,)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in
the State of Florida.
forme=r domiciley riemo~ial of itamil to new omieW~pnrt.hw a~ ~ome,ot~te~~nLLmeat os emplormetat tat
9~-~~'3
FII.E~ ENO RECOROEO
,,.~ c~~~~ ;,.`~~~(
~n'' '!
;,~.tl ppiTRAS} ~``f
~•-,• ~,~~C1E COUNTY, E ~ ~ ~ ~~~~
.•' ,
. : •.~•
~~ 4:'.• lft• : r•
~.~, J~~/-~ ~ `rte` ••v -
I FURTHER CERTIFY that I will register at my local address when the registration hooka reopen,
,__ •~t .,..,_ :.•e,.,o..*. of a tPgstl resident of this State.
and comp,y wu„ u„ :,..,,~, aa.y::........-.. --- - --
~ti
I Fl:f~i~'~•C~ERTIFY that I }~ve no intention to return to my ~tirmer domicile, and I intend to remain
~ •, /
~ ..••• -••-. ~ - gt.Lucie
• •.• , c ~ -. _County, Florida,
~n-- ~ • •* ~.---_T :--~ - Pierce--------------------------, -------
v-+•o-. -
. ,
`` ~ Burton C.Manvilll~)
M • ~ .
r • / • • -
• _ -
..'. C. i
~~.
.,,~ U S•l ~~~~.•
Sworn•.to">~l~~sulyscribed before me thin---Z~tthday of
-----~nue_r3C--------------------------- ~.~• D. 1981 _..
ROGE~POI S, CLERK CIRCUIT COURT,
_D.C. _
(To be a:seated in dnplidte and original Sied wltb Qesk Clreait Court, rand dnplicab ~~- ~'+~ Aatlasor)
,t~w~ BUDDII Co.. PI~Dt Cltr. Bl..