HomeMy WebLinkAbout1829.. ~ ..,
Declaration of Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, •~* ~ ~~ ~~ `
t. Lua~e c_cx,NN. Rowan= ~ ST: llXiF Z~t1117~. ~lA,
This Is my dedaratbn of. Oomkile and Citizenship in the Stah of Florida that 1 am filirg this day in sotordsnoe and
in conformity with Chapter 222, Section 222.17, Florida Statutes. ,
was formerly a legal resident of_______~'l~L.d~.l+1i~-------------------, - HeM_70I't ---------
Key) Ra+d
and I resided at ________-___~9 ~~~~_p-~1$C.~-----------------. However, 1 have charged my domicile
(Bocce end tiunlber)
ro and am and have been a bona fide resident of the State of Florida since-_-_
---------------~H~QOl~LBI'__-_____________-, 19_61_, and 1 reside at
--- -----Font_1'i~cca----------------------- ---- St -
(ciey)
and this statement is to be taken as my declaration of citizenship, actual legal resid
---~~-----------~ ------- day of
Road -
___ 2~10_Mattiiaon_~ca___
(~.«t .~a rwl~e..t
L1lC1e -----____-- County, Florida,
Brice and domicile in the State of Florida.
(I/aert here eny pertinent fecM, suds u wM o/ property ar txrsilleee, or retinquistrllene of elllployrlwnt et tom+a donlidle,
removal of family to new domkile, purdleee of home, NtJ
Establish Residetncy
LU18~1
~ ~I DA~O RE ~p
--- BOOK -
1461 JAN • 22 ~ ._~ 1 = .
_ ;.
SRL UCIE ~OIrRAS, CLERK 4 :Jr ` ~ ' j •: - .
OUNTY, FLORIDA - ::-~ ~ ,~
~~ _ •
I FURTHER CERTIFY that I will register et my local address when the registration books reopen, and comply with all
other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
- r='~ -~ f' ~i , .Fort ..Piert:8- - -- St,__LLtC1e - ---_ __-- -- ___-- County, Florida,
~~ . . , ..... ! ~ . (city) - - - - - - - -
Pe~a~t~V• ' <<'. ..
_ a ,_ . ~,
r~ ~ ^`
I•
1 ' •' ' ,
~ ~
J
'~ Alvar Danberg~'
'r'' ='~
. ~ U ~ l c ~~ - -- ----------- - ----- ...~--- ---- -\ --- - ---
.. :...
Sworn to and subscribed before me this -__--_. -l.~t~l____day of -__-__ -_--_-_ _-.JaA1182~_- -_- - _ _, 19_ ~i2_ _
ROGER POITRA~~S~,~CLERK CIRCUIT COURT
Notary Public
My Commission expires __-_______-__ __ ______-____
(Te he es•cMe~ L ~YrMe yi erieiiel rill wie~ CMrk Cirseif Caere, ae1 JI,'Yreh wNl Te: AeNieer)
e PCO. /T. PI[nC[