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Home My WebLink About4793 Declaration of Domicile and Citizenship ~I~U THI: STATt: AhU ('UUN"TY TA\ ASSt.SSOR, 2448~0 Sf. ('OUNTY, F~LORIDA: Tiiis is my ~I~claratiun ot~ Uomiciir an~1 Citizrnship in thr Statr of Floric~a that I am tiling this day in arcur~laiic~, and in conti~rmity witlt S~rtio~~ ! 7, Florida Stat~~trs. ! was t~orm~rly a Ir_~al r~si~icnt ot~ ~ v~.~f!?~~~1.~-~._- C' ~Z - • - _ . _ , .~nd l (c•~~> ? ts~a~c~ rrsidrd at ~-,C~ , _ 1~- _ _ - - . Howe~~er. [ have changed my domicile to iStrrrt anJ t~umArrj :~si~! am and h.~ve hr~n a bona tide resid~nt of the State of ~torida sincc ~ C-_lrcday oi' _ - ~ . 19 and 1 residr at ~ ~5_Q e-~i~-k''_l~_.~_~l~g--s-- ~ (Strert and Numbe~) ~ ~ ~ Y t ~ s~ h_ _ ~~t~ County. Flarida, - - . - _ tc~~. ? and this sta.em~nt is tci b~ tak~ ~i as my declaration ut~ ritizrnship, artu:?1 iegal residence and domicile in the State ut~ Florida. (Insrr~ hrrr rm• prrtm~nt factc, ~uch 3~ s:?Ir uf pruprrty or husiness, or retinyuishment oi rmplo)'mrnt at furmer domicile, rrmuvrl uf family to nr~~ Jnmicile, purchaxe uf humr. rlcJ ~ ~ V c~ l~ ~ ~I ~.i ~ A ~-h ~ ~ S I ~ ~ ~I ~ ~ h~ ~t ~1 % ~ ~ ~t h ~ LUCIf COUNTY ~~A. IIOCEF PO~TA~S d~ CtERK C+=~ ~,UtT COURT ~ pFCOap vfR:FlEO~~ ~ J~+ ~ 10 ~o ~M'T3 ; . ;~4~8~0 1 FURTNER CERTIF=Y that 1.~~il! r~•~~i~t~r at my local aclelress ~vh~n thr re~istration books mo~~en, and ; rom~~l}r witi~ all c~thcr recluircmcnts cf a le:t.~l r~si~lrnt c~1 this St~te. 1 FURTHER CE:RTIFY th• I h:ir~ ~zc~ intrnti~n to r~ turn to m~• fornier domirile, • I intend to rrmain in • ~~Z-r-c- ~-~-1, _ .~C~~ c( . - - - - _ . County. ~ . - ~ _ F~lor~c~:i.~.~,;s~)snrntl~-. cc~~'. ~ b bY _ cs r IQS F . • ~ ~ = : ~ : • ; • K' . ~ ~ ; ; _ ; ,1 ~ , • ~ - - - - - - - - _ - - _ ;~~[Z ~i _ (Na ` \`O • . = -+L y ~ • ~ . i W i : .pu,g~~~i: r . (Addres~)----- - - - - ~ ~ 'S'•'•;~. ' ~?•~s~' ~ " ~ ~ a~i., tir~~~ ''$,~cc~iy~ ~~~t~~ribrd hefur~ nsr thi, ~a~~ ot- =FCQ~. - - - -.A.D. ty 73 ~ - - _ _ . ary 1'uhlir $IJIr Uf {'Iuflil:l ~f I :1f; ~iy Commission exrir~s l~ " 7 3 bI~?~OJ ~'.l` (Tu hr r~rcutrd ~n duph.atr :~nJ ~~ri~m.~l i~lyd urth I IrrA ('irauil Cnurt, anJ Juplicatc ~+ith Ta~ Acsessot) ~ - - - - - '~.c - ~~'~s°~~?~ _ ~ . ~ rv, i ~ _ , _ s.