HomeMy WebLinkAbout1247 o~aluatlon o! Do~niaii~ and CltizMShlp -
-1.:~4304
TO THE STATE AND COUNTY TAX A~SSESSOR, •
S1. LllC1E COUNTY, RORID/1:
This is my dsclantbn of Oomial~ and Gitis~uhip t~ th~ Stab of Florida that 1~n fiUnp this day in aooordano~ and
in conformify with Chaptet 2Z4. Settbn 2ZZ.17, Horida Shtttt~t.
1 was fonrw~ly a Ipal residMt of ~~?~ls .-(~eor'gia ~
. (C'tty) _ f~a~)
a~d 1 rosid~d at u6 C~iei`r9 Cotart . HovwvK i h~w tharp~e~ my domWla
(SfnM and Numbs~)
ro and am and haw be~n a bona fids rosid~nt of th~ Stah of Fiorida sina ~Y ~
~h 19~, and 1 rald~ at 231~ Horth ~l~st Strssl~ -
_ (Sfn~t ~nd NumbK)
lORT MiRCi, SAINT LtICI! COt!!r1'Y~ lLORIOA - . _
and thi: :tsterMnt is ro b~ taksn s= my d~dar~tio~ of dtit~nahip, actval Ip~l raid~na ~nd domidl~ in the Statt of Horida. .
qnsKt hers a~y p~rtinent facts, wch as sal~ of prop~tty or bustn~s, or niinqulshrnMt of ~nploym~rrt
st former domkil~, nmoval of family fo n~w cbmkile, prrchas~ of homs. Nc.)
RlLEO AND RECORDED
8T. WCIE COUNTY. l~LA.~'
RECORD VERlFIEO q~ldrsn in schcol
1543Q4 _ .
' 'st ~ 28 ~ : ~9 T~Tilliaa Douglas in ~tth Grade
ROGER POfTR~S ~ u'lene in ~d (~rade
CLERK CIRCUIT COURT ~
Pamel,a Cha~c~lene in 1st ~ade
'R Paula Darlsne in lat (h~ade ~
I .
~ -
1 FURTHER t~RTiFY that I will aomply with all attwr nquintr~nis af a lepsi re:tdeM of this Stat~a.
I FURTHER CERTIFY that 1 have no intention to rotum fo my former domials, and I iMsnd to remain in fOaT
PIERCE. SAINT UlC1E COUNTY, FLORIDA, perms~ntly.
~ ~
.
(Na Douglae ~t. Q~ristisn
(~1~ddr~u)
,~,~snd wEuuibsd bsfore ms this 26th ~y ~~Iarch - 19~.
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