HomeMy WebLinkAbout1981Declaration
TO HE ST TE AND COUNTY TAX ASSESSOR,
COUNTY, FLORIDA:
~b3~ 27 ~ 58 ~ .
Dorf ' ' 4YC~i .~ Citizenship
This is my declaration of Domicile and Citizenship In the State of Florida that 1 am filitp this dsy in ao~ordartoa and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of_ ________ ~ _______ ______
and I resided at ____________ _--
(SnNt .ed t~rmba)
However, I have charged my domicile
_~
to and am and have been a bona fide resident of the State of Florida since-____._~ _________ _ ____ day of
--- ------------------------. 195L~!__, ar-d I reside at ----~-- -~ 1---------------
---------------
--- .nd kvmb.r)
~~
-- ---------------'Cd'(~t~ --------------------- ------ -`-c'-~-c'~ ------- minty, Florida,
~) - .
and this statement is to be taken as my declaration of citizenship, actual legal residence snd domicile in the Stats of Florida.
(Invert Mre MY perKnent forth, wch u NM of praputy or businNb a nlinquidrrrnt of oenployma-t rd former do+nicib,
nmovd of fanny M ntw domicile, pwdwe of hon». NcJ
1cr1~J
Fl ANO RECOR~OK
IN
1962 JAN 18 AM 10:23
ROGER POITRAS. q.ERK
St. IUCIE CO~,Y~~A
~;;~,.:... ~4X
I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and comply with all
other requirements of a legal resident of this State.
~~~HER CE~2TIFY that I have no intention to return to my form r domicile nd I intend to remain in
/f~f
`~'~'~'~ County, Florids,
(Gty) - -
permanently.
13ESS M.m.)~s ~~PEti
Sworn subscribed re me this"~.~C.r_::_~, ~ o '•.~' -_, 19`°_ __
._
R POITRAS, CLERK CIRCUIT COURT i .~ • ~ ~+ti ; Notary Public
By - - - - - - - - ---'.p:C., ....;~ ~~mission expires - - - ---- --- - - -------------
- _ __ -
(To M uac,Aal iw titglicN~ awd wrieiwd films vrMlt ~ ttitHtrtf Gwt, awtt d~NcNw vrNM Tut n.e....•)
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