HomeMy WebLinkAbout2286 Fo~ fi. T. C-601-D (liOM-$63) ,
Declaratioa of Domicile and Citizenship 152980
TO THE ~'TATE AND COUNTY TAX ASSESSOR,
. '
'S~ ~ v C 1~ COUNTY, FLORIDA: ~
This is my declaration of Domicile aqd Citizenship L^. tha Stata of Florida that I am filing this day in aooord-
anoey and in oonfosmity with Section 222.17~- Florida Statube~.
, ~G.. ,
I was formecly a logal resideut of ~ w~ 4~
(c~~?) (State) t
and I i+esided at Z ~~X /~S ~O - However, I hav~e changed my domicile
(Streec ~nd Nna,ber)
to and am and have been a bona fide rasident of the State of Florida sinae ~ day of
~ „ 19~~, and I reside at ~s X 4 Q' ~4/ Rf ~ y~~~G~r
1 (Street and Number)
~'o r T' T'e i M G. G. , , S~ 1 ~c i~ _ County, Florida,
.
and this statement is to be taken as my declaration of citizenship, aclual legal residenoe and domicile in the State
~
of Florida. ~
~
(Iasett here aaY p~aent fscts, wch as sab ofp p~ty or ~~t ~~PbY~t at
farmer d~o~icilq removal of familY to nenw domk~ll~ropurc~asa of hame, ecG) .
FtLEO AND RECOR~ED
FI.A.
ST. WCtE Cv~R~FjEO
~ R..co152930
, :
- '61 FEB 24 PN^ 2 ~
- ,
;~pt;`~ ~ OITR~S
CLERK C~RCUIT COURT
~
~ -
f THiS I~ r~~~T Ae; I:: P.I~,:1'FIO:: ~ F-r.r.•.;-~•,,~.~.~ FX '..:~1'IU:~.
Claim fcr the e_,~:._`t.i:.,:; ~s~;-; h~ ~:t.h Lhe Cou;t-
ty '3~x F~ :~~s~::r, e~sc`.i ar.d c:~ ~ry y;,•,;.L•, bata~en Jann-
ary I~t and April ~st. Or such CxempLion oa,YtnoL be
allowed. ~
I FURTHER CERTIFY that I will register at my local address wben the registration books reopen, and
comply with all other req~irements of a legal resident of this State.
I FURTHER CERTIFY that I bave no intention to return to my former domicile, and I intenci to remain in
~v~
r~
~I G ve G sf v C . County, orida,
(~r)
~~~t~y. .
~ - ~ crr~~
, ~ ":.;~•j;4~. ~ #Z ~ ~
Swoi~t,~4~ac~ suL_ b~re me this ~ day of
_ r t*r .
. • . `
A. D. 1
. . . . .
. :1 ; . J' y b ~ _
. • i
. • _ r _'~9 Of J_ ~ f~Y~~ ~ ~SW ~ .
M 'Co~t~ssio~s-eiip~+es si~'6~ 17. 19i~ 3~ 7 7
Y -
(To be e:ecnted in duplicaLe and odginal ~ed with (~erk Gnvit Coart. aad dnPlicats wdth T~ Aa~or)
',tiy,,.rt~~~. gooK~.b4 ~acE2~~SZ ~
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