HomeMy WebLinkAbout0293 Declaration of Damic~ie and Cit~~~nship
2~'~983
TO '~'NE STATE ANO COUNTY TAX AS~'F:SSOR,
. G~'~G~ ~ - ('OUI~TY. FLORIDA:
This is my drrlaration oi~ Domicilr and Citizcn~h~p in the State of Florid:, that 1 am tiling this day in
a;:confance, and in ~ontormity with Scction ??'.1 Florida Statutr
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1 was formerly a legal nsident ut ~ and 1
(c'i~y ) (sate)
. a - - - - n,~ . ~
n:sidrd at _ - - - • However, 1 have changed my domicife to
(Strcet and Number) ~
and am and havr b~;en a bona f~dc rrsident of the State of Florida since day oi -
, 19_S~Y _ , and 1 residr at _~LO - ~
(St t a:~d Numbet)
• ~9~i-~l-[~L.~-_ Coun*.y. Florida, .
(c~~rl
and this statemrnt is to be taken as my declaration ~t citizenship, actual legal residence and domicile in the State
af Florida. - ~
()nsrri hetr any prrtinrnl facts, such as ~alr of p~uperty or businrss, ix telinquishment ot employment at turmer
domicile, removal of family to new domicilr, purchue ~~t hume, etr.)
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F~o ~f ~£~~o
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CLEitK Gi`?y~JtT GOURT
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; 24'7983
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1 FURTHER CERTIFY that 1 wiii register at my local address when the registration books reopen, and
comply with aU other ~equirements of a legal resident of this State.
i FURTHFR CERTIFY that f have no intention to return to my,fornier d mi~ile, and 1 intend to remain in
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_ Z_.,~-~_ - - . ~1~1' ~ ('oimty,
~ Florida, p~rmanently.
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~ ~6s~bcAii to at~l;subs.ribed bcfc~r~ mc this ~lP day of
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~ ' -}r~ - - . .4.U. _
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~ ' - ~ _ A-./ ROGER POITfSAAS, ~i!
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~ (To tx rtrcutrd in dup1N•atr a~.d un~;inrl t~lr+~ ~ci~h ('lrtk Circuit Coutt. and duplicate Nith T+x Assctux)
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