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Home My WebLink About0901 _ - _ . - - . _ . ~ . . ~ ' / ~ ~ 6~al~~tlq~ o~f tfomtclle and Citt~c•Ashtp , , i . ~ . ~ TO TI~ SYATE M1D COUNTY TI1X I~SSESSOR. ~ 51. WdE ~''OUMY. FLORtD/~ . ~ uitbn of Oomki{~ and qd~+ship tn tM Stats of Horida that 1 am fili~p this dax in aooord+na ~+d ~ This is my.d~d . - ie aonfiormib with ~P~ 4Zl~ S~ctia+ 222.17. Fior~d+ Statutas. ~ ~ f • ~ 3CitAN'rON PS~1N. ! 1 wss for~h? • I~ga~ t~sld~nt of . ~ (S!~) i. . ~1?~ ` Hc~wvK 1 h~w ch~np~d mY d~k3~ ~ a~rd 1 ~id~d at 1~ ~ ~t . ~ (StrMt a~d Numb~) lis~at day of ~ b and am and fiaw b«n s bona fid~ rosidsnt of th~ Ststs af i~ida sinae - ~ ~ Pbbra,ar,~ 03 3oath 25th Streat 19 ~ and i rosid~ at t~ ~ and Numb~~ - ; . . ~ NORT ri~CR ~ Lt1C1E OOUWTY. RORtDA - ~ ~ and this stete~r~ent h 1o be tak~n as my dadantion of dtiz~sfiip, ~dusllpsi r'eside++oe and clon?tdk fn ths Stat~ of Horid~• r (lra~rt hete any p~~+t faKts. such as ssl~ of propsrh? or buiiness. or rolinquisF~rns~+t of ~n~loy~ st former domid{s, re~u+o'val of fsmily io nsw doie?tdl~, P~~ase of honns, etc.? _ . ~~C?terimg Geo~6e ~g~pcd~e in the Zth grsde _ lti,r3,'t~o in the Sth 6rs~de . ~ doaaane iti ths lst g~ . ~ - . ~ . . . ~ ~(LED AND RECpRDEO ~ ~11 - - ~ ~ ~1 , ~ - ~ . 19s4 ~ _ - .~OQK ~ : ~ . 3 PM !2, g4 ~ ~ ~ t.~3- . z..~, ~ . . sR0 ~CR ppITRAS~ ~R ~ ; - _ ~E COUNTI', FLORID ~ I . • V - - t , ~ `.•~~~N~~~O~' ~ ~ . . 3 vt l ~ ~ ~ " • ~ - . - ~ " 1N~~1 ' ~ ~ C~~~ ?t18t ~ 1M~~~ - 'j a~~ 01~ faQll~tAfr10f1~t Of a ~A~O~ fQ:l~fit Of ~i S1i1'0. ; thst I have no intsnNon to rotum to n~y former domkile, and f iMend to ?enn~in in fORt ' ~ Fuan~Ea cr~nFlr . . PIEitC~. SAINT WCIE COUMY. FLORIDA, permane~?tly. . _ Gssd - Dorotl~ I.e?1Saos - ~ ~ ~ ~Addr~) ' - 3rd ~ Febrne~ ~r t 9 ~ Sworn to ~nd subscribed b~fo~ ~~+b ~Y ti ~ • . ~ ~ p~.~~~! ~ k ' : ' . ~ ~ • , a:.c~E~t.G ~ O~.C. - i ~ s•. p. R~ _ ~ _ ~ . v• sr~ ~ r; QO~X 8~ PkGE~V1 ~ - ? i ~ ~ _ ~ ~ R. e. ~.~w.a ~ .~a ~.a.,~ a«r~ ~ r v~+~ T~ ~...«~a ~ < ~ ; . . - ~ - ~ - _ - -