HomeMy WebLinkAbout2515D~claratio~ NOUN ta~ . ~ ~tizen:hip
TO THE STATE AND COUNTY TAX ASSESSOR,
St _ Lue~e_~~NTY, FLORIDA:
This is my ded~ratbn of Domidle and CltinKahip in the StaN of Florida that 1 am filing thb day in aooordanos and
in conformity with dupRar ZZZ, Section ZZZ.17, Florida Statutes.
1 was formerly a Ipal resident of-------------~LStOA~a18YLda---------. -----ILL@1ii...YOt~[------
. laM tsn+•t
__-. Ftowever, 1 have changed my domidle
and 1 resided at __-~--ate ~ ~ taMnbad ------
--------------- of
to and am and have been a bona fide resident of the Stab of Florida sinoe___----~2t~L- daY
~~]~~~~~ _-- 19.b1.--, and 1 reside at ----~4~- ~~------------
-------------------^--`---~--------`- • ¢Maa1 .red Nuawbar)
-----------~-t.Pj~ S u~~i.--------- ~MY~ Florida,
~1 ~ ~~_...---- ----
and this statement is b be taken as my dedaratbn of dtizsnship, actual IsRal residence and domiule in the Staro of Florida.
(Inwt Aare +nY parttimM fade. auch w aaM of peopa.~Y er biwMw~. w nlM~quW~k d '"a"~ of fa+.~ar domldM,
ranoaai of fasilY b new domkNa,. pwtLMa d howM, altl
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ROGER POITRAS. CLERI(
Li. IICIE COANTT. Fl6RIBj;~~
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1 FURTHER CERTIFY that 1 will rpister at my local address when the registration books reopen. and comply with all
other requirements of a legal resident of thb State.
1 FURTHER CERTIFY that I have no intention b return b my former domkik, and 1 intend b remain in
----____-- Sty-Lurie _~----------- CouMY. Florida,
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CLERK
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tb M «rwAsi r l~Mu1s ref Ord tMM ~ Cwi Casst- C~ ~ d4Nw rli itaw AsMwd
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