Loading...
HomeMy WebLinkAbout4769 Declaration of Domicile and Citizenship 24'~'796 "f0 " Ht: STr1T = ANll ('OUNTY l'AX ASSt~.SSOR, _ ~ u-l ('OUNTY, LORIDA: This is my ~Ir~laratiun ot' Uomicilr :u~~ Citizrnship in thr State ot' Florid:~ that 1 am tiling this day in arrc~r~iai~ce, an~1 in rontiirmity with Scrtion ?,,.17, f=lorida St:etuics. , ~ 1 was t~ormrrly lrka! rrsidrnt ol~ _~~is~:~:~ ~s~ti~~2-- - _ _ _ _ _ . . --?~~r.~A,..~-~s_~__ a~id 1 ~ j ' Icrty)/'~ (stace) r~si~l~d at / 1~'. ! _.f~.-{1~,~2;L~ ___~s.t~~ _ . Howrver, l havc changecl my dotnicile to (Str~rt and Numher) ana ~m and hav~ b«n ;i bona iid~ rrsid~ nt of the Statc of Florida sinc~~ __-1-`? day oi' , { ~ ~ ~ - f~~,~..~.~.,,-cJ . 19 ? ~ a~ld 1 r~sidr :~t ~1- ~ - --hk:~~~~L----=--'-~ - ~ • } ; ~ (St~retand Number) ~ 7 ~ _1..?~.-*..{ - - - ~ - ---~----~!,~t.~~___-__. (bunty. Florida, (c~~. ) ~nd this statement is to hc tak~n as my de~laration ot~ ritir~nship, artual legal residence and domicile in the State of Florida. (Insrr~ hrrr any prtUnrnt tacts, such as salr c.f property ot busin~s~c, ur rrlinyuishmrnl of rmplo)~ment at fofmrr Jomicilr. remu~al uf (~mily to nrw Jumicile. purch~sr of homr. atc.) t ' 1' ~ / ' i-c. ~ C~.C l~ f ~ . ; ~ ; - ~ " , ; : ~ ' =1 ~i L ~ ~ J ~ ' _4..'-~l ~ 1 ' 3T. UC~F p ~CQ 'R06fR pOU~'~ RE~~ aRy R+ F~~ ~ ~ 3 9 ~ ~ ,~3 . ~ ~ ~~f~ ~ ; I FURTHt:R ('ERTtFY tiiat 1 will r~~~ist~r at my loral a~idr~ss ~~I~~n t}~~ r~gistration books reoprn. ~nd ; com~~ly witt~ ~ll otl~cr requiremer~ts r. f~ c~ te,~a! rrsident of tliis Stat~. ' 1 FURTHt~R C~RTIFY that 1 ha~~e nc~ inte~ition to r~turn to my form~r domicilr, ;ind 1 intend to rrmain in : ~ , , . ' ~----_'l .s~ -__;1,:l1' ~ , ~ . •1_~1,.L_=~~ - • ~~OUilt)', Hlorida, prrman~ntly. ~r~~•? ~u•~ P S - T . ' ,~,~~u„ ! ~ ~ ~r%= i' _ ~ . ~ _ ,.~~r.,,~.,~ ~~vf -!~....~"t _ _ . ~ ~ ) (Name) ° . ~ . E ' ~ ' • ~ : . - •••'n ~ , v~ , ~ _ ' ~,,i i > > ~ / ~ - ' 7~' ' _ ~y. ~.-t<'-_ _ 1 ~ : < < ; - ~.~aa«t.? ; : . ~ : ~xvr~~-t~c~~t ~l~rritic~ hcfurc m~ thi, ~ ~1a}~ of ~ 3 : • ~C A. D. i . , - . , ` ~ , /~1r~ ~j~ ~G~'.~C / _ J'~'~_ . _ _~!IlGC-C~ U if ~ ~ an~ Pufilic S~~tr of } I~~rida at Lar ~!l~;~f 2~9 F~~i . ~ i ~,Ui11Il11SSlOlI l X~11i1'S _ f'"/ 4/~~ (Tu h~ r~rcutrd in Ju~~h..~~c .~nd ~~n~~n.~l fi1rJ ~~rth ('Irr{, ('u~wt ('uurt. anJ .?upl~~:~tr t~7fI7 T3i .ASSCSStN) i s i _ - ~ ~ ~ .^L ~ y~„~ ~ - .C'.`...~~'+x- ...i_~. ~~._v .5......_ ~ . . - _ :.y. -...n... a_