HomeMy WebLinkAbout5207 . Declaration of Domicile and Citizenship
TO TNE STA t: ANU ('UUNTY TAX ASSI:SSOR,
~~~-GGG`-- _ ('OUNTY. F~oK~uA: 245I14
Tl~is s my drrl;ir~ti~~n ~t~ Uomicilr ana Citircnship in thc: State of Florida that I am filing this day in ~
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acrordanc~, and in confarmity witN Sertion „'.17, Florida Stati~tcs.
1 w~s Formerly a l~~u! resid~nt of ~~1%._/._~ /Cl ~~t-e and [ '
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(~~~~Y 1 (Slatr) j
r~sided at G~-~ __~~fi~-2, owrver, I have changed my domicile to =
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and am and have b~r:: a bona tidr r~sident of t4~e State of Florida ~ince day ot
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- - t' ~ ~ and 1 rc~sidr at ~_oG 3 /D " ,/f~-
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• Stre~t and Ivumber)
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--.~'-l~?~e- - - - - - - • ~-~--~-c~~ County. Florida,
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and this statemrnt is to be taken as my dcclaration of citirenship, actual legal residence and domieile in the State
ut' Florida.
(InseN herr a~~ prttinrnt f-rcts, wrh as salr of pruperty or husinrst, ur relinyuuhmrnt of rmployment al formrr
domicilr, rrmo~~al ut famih• tu nrx dumicile, purchase uf hume, etr.)
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t FURTHER CERTIFY tii:it I wilt rr~~istrr at m~~ l~c~l :rddress when ihr re,istratioi~ bool:s reopcn, and '
comply with a1t othrr require~ncnts c~f a l~gal resiclci~t of this State.
1 FUR~TNER ERTIFI' tliat I ii~~~ nc~ intrntion to return to my t~orn~er domirile, and I intend to remain in
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. = E_ L ~ -c ~ c~~=-- - - • County,
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Florida, perinanently~.
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_ David N . Sowerb - -
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~;~'~wo ~ o,:?r~`a~liscribr~l bef~or~ me [hi; ~la~~ c~f
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f' < ~c_ ~ CG'GY~ l C~
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Nutary State ~d f lunda at LarFr O R
s~ok 209 ~~~E z199
~iy Commission rxpires ~rora~r } ~ ~ •
MY CO~ttt,-.*.SStci1-E~. ~ .LS ,THN. ZJ~ 1976
BONDED THRU GCNER.IL 1?IS,::;~+NCE U~,,,«t,ti,i(ERS '
(To br r~rcuted in dupli.ati• and nn~in:J ftkd ~ci~h ('Irtk ('ircu~~ ('~urt, anJ Jupliratr a~ith Taa Assessor)
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