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HomeMy WebLinkAbout1736D~clarotion of Domicile and Citizenship TO THE STATE AND COUNTY TAX ASSESSOR, ~~ ~ 27 ~~n St. j+trc ie couNTY, aORIDA: - o sr, ~uciE rout This Is my dedaration of Domkile and Citinenship In the State of Fk+rida- ~-~~Iin~ this day in aooordanoa and in conformity with Chapter 222, Section 222.17, Florida Statutes. was formerly a Ipal resident of________~Bnd,Qlpti-----------------------. ----Ke1LSOrk_____-- !ah) t>s~ and 1 resided at ___~Fi ~.*----------------------------------------. However, 1 have char~gsd my domidle (3~raat and tl to and am and have been a bona fide resident of the State of Florids sinos___U-__ 1 ___________________ day of } Soles A~anue --- J~-~-----------------------------• 19_-~, end 1 reside at ----------------------------;-- (Shr..t and hiwnbar) ---~Li]Ct_~~,_ ~5~4•.. F4.]CYi_ p~~~p ~--St: LuC3e---- minty, Florida, KM) -------- and this statement is to bs taken as my dedaration of dtizenship, actual {e~al residence and domidle in the State of Florida. QnsaA teen any pertinent fads, suds at aala of poparfy a busMnss. or nlNgvisMna~M of .mploymant of fames domitib. rwnoval of family b nw dorddle, pwchwe of hang. Mtn Applying for horeleatead 101835 BOOK 1961 JAN 12 PM 1:20 it l0 ~~ _. ; ,,,..... a0G CIE C®UNR'~•sFIA f4~•~ ~ `' •'' .eft- - :l ~ ~~ '' ~111~1••~ ,; •'~ ~.1 1 FURTHER CERTIFY that 1 will rpister at my local address when the rpistratbn books reopen, and bbrnply with all other requirements of a lapel resident of this State. I FURTHER CERTIFY that I have no intention to return b my former domkile, and 1 intend to remain in „~. st. Lode ! ~ County, Florida. .•~ f~ierae ---- ------------------------------------ 4 .'yrr~ • i 1aM p~1., ti a '-. ~ ~.V.~~: •.r'r n ,% ~~~~~ ..... '' ..Stet- - ---------- .,~ r Q ~ . ,• r•' t~Mat . , ,,t ~ r __l, _.. Y~.. -Sworn to and wbsCribed before lrle this-------~--------day of ------~-•----------------- __~~~t,ras~ a _._~---- ~ ------------------------- / --Not Publk ~~~F v~s'R~~ ~ C,ot~mission ------------------ ------------------~ . ..,~_~___......_ OuG. -------- ~ ~ (Tir h....«..r r i*irls a~ «ISWt tY .Iti ~ CtneR bn1, .•/ irll..i..w tea Aanesd aroo. rt. ~rswot .