HomeMy WebLinkAbout2325 Declaration of Domicile and Citizenship
24320'7
"f0 THN ST E ANU ('OUNTY TAX ASSESSOR.
,
: _ ~%~f~~ ('OUNTY, FLORIUA:
Tliis is my drelaratian oi~ Uomicil~ and Citizenship in the State of Florida that 1 am filing this day in .
accor~lancc, and in conformity witii Sectio~ ?.17; Florida Statutes.
1 was formerly a Ic 1 residcnt of ~ ,~~'cv~a~~u~s-c~~ and !
~r/l / , L/~~(:itY) (Statt)
nsidrd at _ ~lf"_~,~~'~`"~~ .
. Hawever, 1 have changed my domicile to
(Slrret a~J Numbrr)
:~nd am and have becn a bona fide residcnt of the State of Florida since ~ _ day of
~tP~s~'C~G~Gt--- • 19 , and 1 nsidr at ~OD-- -
(Strcel and NumDer)
- - . -~f~~ ' County, Florida, .
- - - ~ -
t~'~~r)
aiid this statement is to be taken as my d~ciaration of citiaenship, actual legal residence and domicile in the State
of Florida.
(Insrr~ hrrr any prrtinrnt facls, such as salr of pruprrty or businrss, or rrlinquishment of employmrnt at tormrr
domicJe, remoeal of family to new domicile, purrhase of homr, rle.)
~.(~L7~(~i./~
' ' FlLEO AN~ RECWtOEo
p S7 l~1CtE ~JUNT1' ~tA.
~ ROCER POiiR~s
CLER[ C1~C~?IT COURT A~C
RFCQRA VER:rlED~.~,.,~
~ ~ ~a 05 ~ '11
24320'7
1 FURTHER CERTtFY that I wiit rrgistrr at my tocal addmss when the registratiot~ books rcopen, and
I comply with ail other requiremrnts of a Icgat resident of this Siate.
~
! I FURTHER CERTIFY that 1 hav~ no intention to return to m}~ former domicile, and I intend to remain in
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' Ic'ity) - COUllly.
~ F{onci~a: ~e~~anently.
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ti: twaar~ui
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~"SK,A~~,to"~ci s«bscribed brfor~ mr this day of
' _c~~c_c.. - - A.D. 9 _~Y'
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S!l/ Nntary Public State of t da at~r~r
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: 141y Commission rxpir~s ~ - ~lp_-._[ _ - b~20~
.
ITu he rarculed in duplir~te and unginal tiird ~vith ('lerk ('ircud Court, and duplicate with Tax Assessor)
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