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HomeMy WebLinkAbout2530 D~ctaration of Domiciie ~nd Citizenship "fU THI~ STATI~ Ai\'l) ('OUNTY TAX ASSi:SSC1R, ~~~-~'l-~f _ ('OUNTY. f=LORIDA: ~4y`5b1 Tl~is is n~y d~cla~ati~~n ui' I~micil~~ :md Citircnxh~p in thc Statc ol Florids that { am tilin~? this ~iay in arcor~lancr, a~~d in cont~onnity with Se~ti~~n ,,,.I7, Flonda Statutrs. 1 was 1'ormcrly a ir~al msi~irnt ot~ ~e :zz_!~ u 6-~/ - - - - • - - _.:L~ n • n-,•~_- :?nd l (c•~~r~ (s~a!e? - fcs!(1Cd :!l j} . ~ - - - - - - - - - - - _ - _ _ ~ . Nowevrr, 1 have changed my domicile to (Sirrrt •rnd lVumtxr) and am a~~d have tkrn a bc~na fidr rrsident of the Statr of Florida since _ 2~ G~~~~ y oi ~p~ - - _ . . 19 ~ y ~ and ( rcsid~ at _ .2 - ~1l,~= ~ ---J r ' _ ~ ~ IStrert and Nnmber) ~ f't . l _!_£/Z~-~- - - - _ • ----~'-~/1' COlplty. Fl~rida, (c'it> ) - - and this statement i~ to b~: iake~~ as mp dr~laration of citi-r_enship, actual legal msidence and domicile in the Stat~ uf Florida. (Insrn herr any Crrt~nrnl facts, snch u salr ot property ~x husinrss, ~x rrlioquisAment ot employment at formzr dumicile, rcmmal uf famih~ to ne~v d~.micilr, purch~sr uf humr, rtcJ ~ LL'~G V~s ~ ~ r~ ~ 'S ~1.~ . L' FILED Akp :~ECVROEo ST. ~GCiE COUHiY FLA. ROGEri P~~iTRAS CLERK Ct:;Y~;T COURT RFC~~~~ i~~': ~:EJ Mar ~3 li o4 AN'73 ~ z4yss~ 1 FURTHE:R CERTIFY that t will rr,,ister at ?m~ loral acldress when tlte registration books reopeiz, and romply with all othcr requirements af a le~al rrsid~nt r~f this Statc. ` 1~U HER CFRTIFY that 1 ha~~c no int~ntion to mturn to my fonner domirile, and 1 intrnd to r~main in i ; C, ,r~~ ~ C,i, i'~~Gc~c , ~ ~c'ih) _ - - COUIIt~. ' .~'~7~1__•s~};t3fR1 ~lsA~~?- , . - ~ j ' ~ A _ i • .y . ~ G ~ ~ ~ L+rts~ _ •_i'~~ ~,4,= -~f L' ~ ~tiante--- - - ;,r.:.. f _ : v ` ) ~/3H~sc D~ . : . ; . ~ • - - ~ - , .4 . _ , . .t . - - O ' -U~f1i~ ~u_- J - , G - - - • ~ (Address? Sworn'to and suhsrribed befon me this ~av of ~.~h A.~~. <<~ _7 3 . I ROGF~PQtIBAS~-f,tedt- - - - - - - - . - : `.<<L.,`' ~ ~ , ° p 211 PA~~2528 ~ 6G.lK ~ (To be rcrcuteJ ~n duphcatr and ~~ri~:~nal filyd ~vith Clrtk C~rcu~t C'uutl. and duplicatt wiih Tax Assessor) r . . - . - i - - .F ~ ~ ~ _ > . . _ _ - .~_~_,r-=~~~