HomeMy WebLinkAbout1527 Declaration of Domicile and Citizenship
"I~O TH1: TAT~ ANU ('UUNTY TAX ASSt:SSOR. 242s25
.
- _ _ ('OUNTY. H LORIUA:
"fl~is is my cl~rlaratiun c~f Uomicilr and C'itizrnship in thr State of Florida ihat 1 am filing this da~~ in
acror~tan~~, :uiJ in conti~r~tiity with Scction , Florida Statut~s.
.
1 was forn~rrly a Irgal idrnt af - • ---~C~_- ~nd 1
- (CitY) (statr)
r~sidra a , - - . - - __-~/'y Howe.ver. I have changed my domicil~ to
(St~~rt and Numt+er)
and am and l~avr b«n a bona f~de rrsidrnt of' the State of Florida since _ f~ day ot'
^ ~ -
~ - . 19 a~id ! residc at ___-3<~VQ'i.+~'~-
' ~ (SI~ t and~ jN
'~mber
-.~-e~~--- -~~~t-~~- ` ~u~c.~ County. Florida,
(c~~x>
and this statement is to b~ tak~~n as my derlaration ot' ~itizenship, actual legal residence and domicile in the State
uti Florida.
(Insrr. hrrr an> perlinrnt facts, such as sak of pruprrh~ ur bu~incsc, ur rrli~quishment of empiu}~ment at formrr
domicilr, rrmu+al uf family tu nc~~ domicile. purch~sr uf humr, atc.) "
~
_ ~ . `~G~ ~
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ST~~
C E COUNTY ftA
ROGER a~rTRAS `f
ClERR ~ra~u~T COURT y~ ~ j
Rf.~CP,D VrR+FI~~ 1~' I
~
~ ~j ~0 4o AH '71
. 242625
1 FURTHEK CERTIFI' t1~at 1 K~ill rc~;ister at n~y loral address when the registr~tion books reopen, and
romply with all other requirements of a lega! resiclent oi~ this State.
;
; 1 FURTHER CERTIFY that 1 ha~~c no intrntion to rcturn to my torn~er domirile, and I intcnd to remain in
' -e., -
~,,..~~,~;~_-~+~"`"u- ~ _ County.
i Flo~idsy. pf~r~'~(oglly. tci~yT
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' ` i = (Name) e
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: 'r~' • lAddress)
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Swenn'~~~~A~t~bscribrd b~fore me thi:~,_ etay oi'
'
' ~f ~ P /?7_. %J P - - _ A. 19 yi
,
--~~t - ~ ~ - - - - -
~ ' Noiaty F'ublic Stale uf Elnri l arRe K;,T~11i`[ P1iBI:% ~iA7L Of (1G:i`~.: AT tJ1YiE
~i~ i;ve.~:.~~~~1U:1 ~,i?N:: • ~t3. 1(~. ~97~
~ Bi1.1t~::~ 1MA11 iRZ.I! M. L•:E:.ICis~ciKjT ~
`iy Commission cxpires - - - - - _ ~ - -73
(To be rvecuteJ in dupli.atr and oriRin:~l iit~d Kith C'lerk ('ireuit Court, and duplicate with Tax Asseuor) .
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