HomeMy WebLinkAbout1382:--_- -- OWI~
D~claarotion ~t TY~ ~~. ~ ~ en:hie
TO TFIE STATE AND COUNTY TAX ASSESSOR,
9t. Lneie rn11NTY, f10RIDr~
This is my dadaratbn of Domidla and Citiaar-shlp In the State of Florida that I am filirp this day in aooordanoa and
in opnformity with Chapter 222, Section 222.17, Honda Statute.
I was formerly a Ipal nsldant of--------~l~i-- ~-- ; -------------. ---~Q~-i-----------
and 1 raided at ________.SD-.Z~ S ~aO~Qh3.4--------------=--• Howvar, 1 haw changed my domidle
to and am and haw bean a bona fide raidant of-ti!~ State of Honda sins---~~--------------------- daY ~
-------------~~i~--------~~~~_~__, t9_~~_, and I rwida at ---~_~~~~8~g~~ R4a~---
c~ «.a ra~.e.-t
--------1t~t_~,isitc~_ ~ ~ St~~nci ~___~--- co~ntY• •
tangy
and this statamenf is to ba taken a my daderation of dtinenship, actual lpal rasidenoa and domidle in the State of Florida.
t
p~ h~a Mw pntM+wM hW. wd~ w MM of p,o~,ly a tMwYw~, a r~wek d ~1°y"n'd d ian~r da~kN~, ,,.:~
r«no+nl d f~qr to ,rw do~teN~. Pam of tam, lei
•pplyiatia for- hoaestead eseptioad
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Establish Resideacf
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i H,IRTttQt CERTIFY that i will rapistat at my total addna when th. rapistration books raoP.n, and oflmply with all
other raquirarrwnt: of a lapel naid«tt of this Stag.
1 FURT11Ht CERTIFY that thaw no inta_ntlon to ra~urn b my fomMr dornicit~, and I inland td nrnain in
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