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Home My WebLink About0649 2~t321'7 Declarat~~n of Dornic~te an~i Citizenship TU THl: STr~TF .1NU C'OUNTl' TAX ASSt:SSOR, ST. ~ ~ e ~ ~ - _ _ c'OUN7'Y, t= LORIDA: 77~i, is my d~clar~liun ot Uomicitc and Cit~zcnship in th~ Statc of Florida that !:+m lilin~ this Jay in :~rro~aa~~«, :ind in cc~nfonnity witlt Se~tion "'.17, Florida Statutc~s. 1 was fornierly ~ I~~;al r~sident ot~ , _ . ~--o~tC ~~~_DL_-- - - - , ~ ~ 1 o'b-` ~ and 1 r tcuy? ~s~a~r) r~si~lyd at l? ~-0.5-} _ _ 1 . --~'~-~c--~'E-"~------_ _ - Nowever. [ li~ve changed my ~omirilc to (titrrrl anJ Numbe~) and am and have txcn a bona fidr r~sidcnt ot~ thc~ St~t~ of rlorida sitt~e day of ~ ft~,` ~ U-~` I 9_ 1~, and 1 residr at ~ tSC~.L~ _ ~~'Y'~ ~ - - - • - ~ - _ (Sttrrt and Numberl - o.''~t - ~ 4 ck"-~' -G'- - - - - - - - - ~ - • ---__~~1-~-.- - County. Florida. i~'~~v) a~~d lhis s[~Iemini is lo be takrn as my declaration of cilizenship, aetual legal residence a+~d domicile in the State uf Florida. (lnsrr: hrrr an~• pr~linrnt (acts, such as salr uf proprrty nr bus~~~rss, u~ rriinyuishmrnt of rmploymrnt at formrr domicJr. rrmoval uf tamily to nt~v dumicilr, purchasr of homt, rtr_) h-~4- ~.-r v?~ d ~r- t,~ t~.l ~ C~~..v o~ ~ c4821'7 =;~~o ~~c~ROEu ST LUCi~ C:;~VTT FLA. RC~:,- = :~~:'RAS CLEf~ ~;1 CDORT °F~'~'~~ v__,_ ~J FEe 21 12 26 PM '13 . ~`y t FLiRTFIf:R CERTIFY thc~t 1~~•ill rt,~ist~~ at my l~ral .~ddress ~vhen the r~gistratic~n books reopen, and cUm~~l~~ with a!1 oth~_r reqt~irrm~nts c;f a 1~,_al residrnt of this ~tate_ I~URTHER CERTI~=Y tt~at 1 h~~~c no intei~tion to return to my fomier domicile. and I intend to remain in . - ~T,r'''~ ~±_~r e - - _ ~ ~ t - • couniv. - - - • - _ Fiorida. p~rman~ntly. ~r~t.~ ~ ~ , ~c;; : ; ~ ` f•- , - - ?E~i~It~",._ s c~ ~'.-t} ~ ~-t'•.~- ~ : . . - - ; ~ va o~mf~ : c' . . _ _ : . . _ . . ~ : - ' ~ u C~,~ C ~ _ f ' ~ ~ . . _ _ - - - ~ - - ^ ~ : ~ ` (.~ddrrst) . ~ j~ Sy?p~nio-aji~'~~fiscribcJ hef'~rc ~~ir tiii, 4ay c~f '-r,~ rt~n~.}.'`. ~lt~..... - - _ _ A.U. 1 . ~.~_,1..~ - ~ ~ Li,c.{~ - - lL-- - - - _ _ _ - - No~3R-~ublic Statc of I~~riJa at larec ~ty Commission expires _ / d ~ y7 ` ~ ~ (T~r be raerutrd in dup?icair rnd nri~inal filed ~sith ('icrk Citcuit Cuurl. ~nJ dupl~catr with Tax Accessrx) 6ooK 21i PAGE 649 ~ ~ - - ~ ~ - . - - _ ~ _ .