HomeMy WebLinkAbout1056 ~ O~aluatlo~ 01 Oomiatl~ ~d CitlsMShlp
T'O 1ME STATE AI~ COUNtY TAX ASSESi~OR, ~
Sl, ltJC1E COUNTY, FlORtOA: . '
This is my d~cl~r~tion of pomidl~ Md Citi~nship in tM St~t~ of Norida that 1 sm fili~p Mi~ dar in aooordana and
i~ conformily wiM ~l+ap~ Z~. Sation 24~.17, Norida Statuta.
~ w•: ~orn~~r a t.qd .~~d~r?t of areent;,i,~. lia9e.
~ ~ (City) tStat+)
~nd 1 hs~d~d ~t 23 arave~ 8d. : No~a~vu 1 h~w cfiar+p~! my domidl~
- ~ (StrNt and Nh,mbK)
b and an~ and haw bMn a bona-fid~ nsld~nt of th~ StaN Of Florida ~ince lAt ~ day d
~~°t , t9 70 , a~d ~ ratd. a '~05 S. 29th St.
tStnM and Numb~~)
1~ORT INiRCl, i~A~IT i~ICI! COUNTY, ltOR10A
and this :tata~r~t is ro b~ takM as my dsclaration of citi~nship, utual Ipal r~aidena and domkil~ i~ tlw Shb of Fiorjda.
qnsKt Mr~ any ptrtinsnt facts, wth as sal~ of proparty or bu=i~u, b? hlinquishm~nt of ~tnplq?m~nt
at former clomidie, reRwvaf of family to n~w domkil~, punhas~ of horrN. ~tc.) ~
(Homeetead ~ceaption)
~ 'Fil'~tD'ANO~ RECflRRE1~0~.
ST: IUCiE COtiNTY;
RECORD VERI~IED -
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. 'TO AUG I Z PM 3
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ROGER POITRAS ~
CLERK CIRCUIT COURT~
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1 RJRTHER CERTIFY that 1 will aomply with all othw ngui~ts o#. a Ipal raid~nt af this Sta»:
t FURTHER CERTiF1l that 1 have ra intention ro rotum to my former domicil~, snd I intu?d to nrnsin in FORT
~ P~~, s~~n waE couNnr, FLORIDA, ~n,a~anriy. 8lchard d. 3u11 i~an
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SMrom ro and wbscribed befor• m~ this 12th -~r ~ August 19 ?0
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~ . D.C. My Commiubn .xplr.s
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