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Home My WebLink About5305 Declaration of Domicile and Citizenship ~r~ -rrt~~ s~r-ATf= AI~I) (~ou~z~~~ -rnx Asst:ssoK, 245154 ~T ~.~-~t'OUNT1', f=LnRIDA: Tl~i: i, my chri:~r:~tion al~ Uotnicilr ,ind Citizrnship in thc Statt: of Florida that 1 ant tiling this day in arror~lancr, an~i in cunformit> witli S~rtion ,,,.17, Florid.i Statutrs. t~/ 1 ~ 1 ~vas i~ormrrly a !<<,al r~si~lrnt ot~ _ _ - _ . - - _ and 1 (('ity) (Slatr) i r~si~ied ;~t _ ± _ ~F-_~ ~ _ _ . Howev~r. 1 have changed my domicile to : ~Strrrt ~nJ N brr) an~1 am and havr br~n a bona irce resiclent oi~ th~ S• tr of I~lo ~ a sinc~ day ot ?~~..~-~.~t s - _ _ ~ . , 3_ . ~ ~t P_Q_ : . ~ (Sttee4 and Numbrt) ~ _ _ . _ - • - County. Florida, i ~ tt.~.+ and this statement is to hr tak~n as m~~ ~I~rlaration uf citizenship, actual legal residence and domicile in the State ot~ Florida_ (In~rn hrr~ an)' prrhnrnt fact<, wrh as sata• ni p?uprrty u? businrss, or rrlmyuishmrnt o( rmpluqmrnt at formrr Jumicile, r~mu~~l of (am~h~ to nrw dumirilr. purcha~ uf humr. ric.) C / l~~ ~ " ~,~.e- ~ ~ ~ ~ ~ ~ ~ . ~ f t~Eb ~uro ~o , ~ i ~~c~E co~MTr~i~. ~OCER Pp~TRAS CLERK C+~CUIT COURT RFCOFO vEF+~lEO~,,,~~,,,~~-~-~ ~ , J~, ~ I4 aH ~~3 ~45184 ! FURTHI~R CERTIF~' that 1»~ill r~t~ister at m~~ loial a~l~iress when the registration~books reopen, and ? ~un~~~ly with :ili ~th~r reyt~ir~m~nt, of a Ir~~a! msielent c~f this State. I FURTH~:R CERTIFY that 1 h~~e nc~ intention to return to my forn~er domiciir, an~t 1 intend to r~main in ' ~ • ' : . - ~-o-,~-~_f . c~ • . ~ - - - ~ . _ . -c~~~„t.-. f~Iuri~ia, ptrntan~nti~. ~c ~ . ~~.J~l/~ l - - _ - - - ` ~ 9~J /~E~' Na ~Name)~ ~ I 5 ~~~i17/1f/5 ; 1•S. ~ ~ ~ , ~ . . . . . _ . ~ . _ - - - , . (:1t~.~f~SSj `,,,~1^111 ~~,~I,,,' SwuT~~tP:;~~,~~,sG~jbr~l brti~rc mc tl~i. ~ of - ~ ~•~J ~ `7 3 ; ~ = ~ - A. D. t . _ O _ _ ~~C.1 . ~ _ ."~a • A~ Warrl~t+lic titale ~rf {l~~r~ilr al t_ar ~ ` ~ ~ ~ R 297 fir ' tss ~ o~ i q 7 3 600r 2~9 ~t~t 2 ~1~~ ~niui lo r~ r~~ . /Tv hr r~~•cutcd ~n du~hcatr anJ un~;in.~l fdrd .~rth i'IrrA ('uiuit l'~~urt. rnJ dup6r:~le ~~ith Tax Assesscu) . i . ~ . - . - ' e'~ . ~ M:~.. - . _ . . . . . ~ ~ > . _eu`-~'*.~~.