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HomeMy WebLinkAbout0725 Declaration of Domicile and Citizenship 242oso "I'O T it: STAT : ANU ('UUNT~' 7'A\ ASSI~SSU{t, - ('OUNTY. FLORii)A: Tliis is m~~ ~irrlaratiun c~t Dc~rnicilc c~n~i ('itii~nship in t1~~~ Stat~ 01~ Florida that t am iiling this day in :~ccordancc, a~ut in r~nlormity with Scction „'.17, l=lorid.~ Statut~~. . 1 was i~orn~rrly a hgal r~sidint ot ~-~L~r-_- _ _ - - . ~vt~-• :+nd I ,Q,,(_ ~c•~~. ? cs~4~r? rr,ided .it ~ _ _ _ _ . Howrver, t twve changed my domicile to (Strrrt and lliumbrr) ~ ~nd am and liav~ bcrn a han,~ ficlr rrsictent of !he State of F~lorida since day ot ~~'~Z. . 19_~ Z. ~nd I msidr :it 3 ~ ~ ~ _ . - - - . - - ? ~ ~ Stteet and Numbr~ ~ - ,(~~'~-~-Q-- ` . _ _ _ . . . - - L~"'=-' -~-~-~--~~-J County. Florida, Ic~t. ) ai~d this statemrnt is to be takrn as my dr~laration ut- ritirrnship, actuai legal residence and domicile in the Siate uf FloriJa. (Insrr~ hrre an~ prrlinrnl f~ctc, such ai wle ut pruprrty or bucenres, ur rrlinyuishmrnt ot rmployment at formrr dumicile, remocal ~~i familr tu nr~c dnmir~lr. purchasr of hnmr. rtc.l ~ v`~'~'~-~ ` ~ ,(~.sn.,, ~~--'~--L~l~`~~ ~ iflEO ~tA3 f~EC4ADF0 fT. LtIC1E CU1N/1Y ~u RQ~FY ::,?7RAS CIEftK ;.:;.GSIT COURT ~ . PfCC~a~y~~:~~::D ~br I~I 2 06 Pt~'r2 242050 1 FURTHf:R CERTIfiY that 1~rill r<<,i:trr at m~• lo<<~i addrrss when the r~~~istration books reopen, and i comply with all other rcquirrr~~~nts oi a lr,_al r~`icient ot this St:tte. ~ 1 FL)RTHER CERTIT=Y that I ha~•e tlo intr~ition ta rrturn to my fornier domicile, and 1 intend to remain in ~ . , , , , ~ ~ . . • oun ; , ~ ~o-- ~ - - - - - - - _ _ _ . _ - - - - - - , y . ~I~iS~+„~iest~jrsttt}~. ~ ; ~ ~ , „ , . ~ , , , . . . ~ . .r ; i,. ' ~ • - ~ V ~ ' v " . yq- • . C~~ - ~f . r, m. ~ - - fi t~ ; _ 0? 1 i (Name . " ~`~a.~'.' ~ .v - r~ ~ - - - - - - - l ~ C 0 . ~ ( AdJrrss) " L Sworn ~to and sui~scribed hefore me this dav ~~t~ _ ' ~ ~--C..'-t,'7 D 1 7 ; ~ ~ • . ;1. . _ ; --E'~,, - - - _ . . : : . . ~ . . ~ . • CV ~ 1Q'; . ' ~ ~ • - ---'.-~.1-~- - . _ - - - - . . _ . . . : i-~ r ;f~?j3Jy Puhlic Stala of Fl~irida at Lar - i ; . ~ ~ ~ _ • ~ ; : ~ : ~ : ~ ~ ~ 0 R ~ r~~t ~ ' ~ = My~C~lfniss~expirrs ~'~-~L.L ~O~ ~ SOOK~+vU ' - _ _ ~ ~ = ~z . . , _ f, ITo br r~ecutrd in Juplicatr anJ ~.ri~;inal fikd .~ith ('Irrk ('ircuit Cuurt. and dupli.atr with Taz Assessor) ~ ` . - ` 3 "",T~ ~`"~,.~?~s t.. 9~'*~~~~ ~Y ~~`n"y~~„-..:. • ~ s~.`~,~ . w..i . . _ ~F~~'~~~~