HomeMy WebLinkAbout2309~t - 28 r~cE1?
Decivrotion ~~, ~~y° .~C'itizen:hip
TO THE STATE ANO COUNTY TAX ASSESSOR,
_$t.~~lC1d._000NTY, HARIDI-:
This is my declaration of Domiu~'!e and Citl~anship in tM Stab of Florida that I am filing this day in aooordana and
in conformity with Chaplet 222, Section 222.17, Florida SfNuNs.
Bre;~tKOOd Nen+ York
1 was formerly a legal resident of_______~.~---------- ~ ----------------• ----------------------
{ia~d
and I resided at __1~~-Br~@ate[04d-~tii.------------------------. Fbvve~ror, 1 haw changed my domkile
Wna «d Mkt
to and am and haw been a bona fide resident of the Stab gi Florida sina__: 2~.$~e------------ -------- d+Y ~
_~, 19_x, and I reside at ____321 S~nriee_B1Vd~___--
-----,u~us2<------------------------ {31~.M aed Nusb.d
----------~Z.-~~~'~~--=-• --- ~~~ Qt t~ni ~~_w--------- AMY, Honda,
and this staternsnt is to be taken as my dedaratkan of dti~enshtp, actual Isgal resklenoe and dornidle in the Stab of Honda.
pir..r two any p~rtM~Mif hWr wd~ a~ ~ d prop~rlr or ~wM~, a nMngMdrM~ d wplsr~wnt M forww. do~itW,
nmwd d filly to Mw ra^1dMr W~'dw~ d hawM, Mal
gstabliah Residency
jt.
.- fi.
~a: OJ' ;'' .; .
.~~... ~,; . J~., .
..i~~~ NIw
v ~ ~ ! .
~. ~ •~
.....
102160
a~~~~ ,
N
(962.NW 23 AM I I:10
ROC€R POITRAS QEAK
st. ~r~ie ce~r~ia~
1 FURTHEII CERTIFY 1hN I will tplstet at my loin addtea when the npisttatkxl books reopen, and comply with all
other requlremerNs of a Ipai resWern of this Stab. .
1 FURTHER CERTIFY that 1 haw no lnbntion b rrlwn b my former domkile, and I Intend b remain in
4;
4 s •~
~-~ JI
S
~. C~3, 'cY~:~,~ .
~. tit ~•'%!A ?. .
~. •~
. Do>aald Ran °r'"'r
._