HomeMy WebLinkAbout1910 ~ ~
rU TN~ STJITE ~NU t`OUNTY TAX ASS~ SSOR, ~~R~ ~`~a3
C'OUNTIr, FLORIDA:
This is my drelaration of Domicile and Cl'titc~iship in the State of Ftorida that t am filin~ this day in
acconian~~, and in ronfo~nity with Sertian ?=2,17, Fto~da Statutes.
! was Cormerly a lega! n~ident of v~- • and 1
, t ~y1 (se.a)
rcsided at ~ . Nowever, 1 have changed my domicile io
(Stnet N~wle~)
and am and have been a bona fide resident of the State of Florida since day of
, 19~~ and 1 reside at ~ ~
~ (Street aad Numbu)
~
• , -~~C~~--~ County, ~lorida,
(A'fY)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
• aae anr a*e~~ s.c~s.:~ :s sa~e ot w~v~r or e~i~ss, or reunq~~n~e~~ ot ~maormea~ at fonaer
doiaicile. remoral ot fa~ai~r to aew domic~e. Purd~sae ot eane. etc.)
:
~Ra SiRCU~T ~1T,~1~ ~
~ It~¢9R41?ER~tEB.~.~l:..
- A~r~t 1~1 41i PN'7Z .
22~'963
1 FURTHER CERTIFY that I will register at my local address when the rEgistration books reopen, and
comply wiih aU other requirements uf ~ Ic~al rc~sident of this State.
I FUR ER ERTIFY that 1 have no intention to return to m former domicile; and I intend to remain in
.
" , County,
Florida, pcrmanently. «'~Y~ •
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:~~=tp_ arec~;s~'Ded before me this day of
';,r `
~ ~ A.D. 19 7 Y-
8~$i1~~ ~TRA3, Clert Circuit Co
: ~ D.C. -
(Tn Oe e:ecrted iw dnplicate awd wiRiwal tied a~ritl~ CIerR Cirrit Cortt, a~d dnpdcate wit? Tas Apea~o~)
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