HomeMy WebLinkAbout2761~b~K 2~ P~c~630
Declaration of Dc~g~ic~~~~T~~~°nship
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TO THE STATE AND COUNTY TAX /-SSESSOR,
e~ T..~ni a COUNTY, FLORIDA:
This is my declaration of Domidle and Citizenship in the State of Florida that 1 am filing this day in accordance and
in conformity with Chapter 222, Ssdion 222.17, Florida Statutes. Ohio
Cleveland _______
----
was formerly a legal resi t o __----_----- ~•rt
4609_ Loraine Ave. ______. However, 1 have changed my domicile
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and 1 resided at ____-__---- ls~t ~ ta~+b.r)
to and am and have been a bona fide resident of the State of Florida since_
----------- QStc4~ler----
1st-------------------p~d'~t°.~1.,uci
111 El Sito Cotarzt --
_, 19__ ~?l, and 1 reside at ------------------------
----~ ~t--Ei~C~---- (ah-)
_~.~~~a1+31~~.-------------- ~ntY~ Florida,
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
i•cts, wctr x wl• of prop.rb or bvsYms, w nlfnqui•trn•nf of ~PbY^~^~ of former domkil•,
(Invert ti•r• «rY p•rtinMf of han•, Mc.)
rnav1 of f•m{ly to new daniclM, P~~~
Establishing residency
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~p pHp RECOR WOK
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1962 JAN 31 Ph 12:22
ROGER COU S~(,SflO~A
qj, lUC1E ~ C
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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. -
I FURTHER CERTIFY that I have no intention to return to my former domicile, snd I intend to remain in
$t.1,tlCie ____-_______ County, Florida,
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_ F~wr~P~rccMr~ ------------
permanently. ~
I atius C. Ki~E
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Swom to and subscribed before,~>tld~-.~-- -.-
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