HomeMy WebLinkAbout1932 ~
De~c~aration of Dor~nicile anc~ C~tizenship
TO T1iL' STAT ~ AND COUNTY 'TAX ASSESSUR,
° 249108
_ _ COUNT~', FLORivA:
71iis is my declarstion of~ Domicile and Citir_enship in the Statc ot Florida that 1 am tiling [t~is day in
accordancc, and in c~nfonnity with Sectio~~ ???.17, Florida Statutcs.
! was formerly a legal rrsidrnt of __~--!:1~~~ ~ and 1
tc•~~r? ~s~a~el
_~-~~%3~~ ~ - -
rrsidrd at . Howc~er, I h:~ve changed my domiciie to
(St~eet and Numbrri
and am and have tx~n a bona ~de rrsi~lent of th~ State of Florida since day oi
/GD Lr.~s•y `
- . ~~~a i r~s~a~ :,t - ~~e
~j~ ~(Street and Number)
- . ~.~c2=/` c-c.! County. Fiorid;~,
(c~~> 1 -
and t:~is statement is to b~: taken as my derlaration ot' citizenship, actual legal residence and domicite in the State
of Florida.
(losrri here any prrtinrnt facts, such u s.ila of property or i.~sinrsz, or relinquishmrnt of tmployment at former
domicile, rrmo.~al ot family to nrw domicile, purchasr of home, rtcJ
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Ci~{ Si.~.YLiE G(~~yy7YF1~ 1r
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~ ~
~ j ~2 3i P~# '73
249108
1 FURTHER CERTIFY tttat 1~vi!! re~ister ai my loral address ~~~1ten the r~gistration books reo~~cn, and
comply with all oiher requireme~ts of a legal r~sident of this State_
I~URTtIER C' TIFY that I have no intention to return to my fornier domic' e, and t intend to remain in
/°i . ~
_ _-s- _ C~G _ County,
Florida. permanently. ~ (r~~• ~ - - - - - , n
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~ ~'~vof~f tp~3n~4s~i~bscribed before me this d~~• ot
g ` - A_U. 19,~~_
ROGER POtjRAS~ Cte~R
_ ' - ~a aooK 211 PACE ~.9~
~
( i~ be rxrcuted irt duplicrte arrd ~r?lKIRdI I/IC(~ with Clerk Circuit Cuurt, and duplicale Nith Taa As.sass~~rl '
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