HomeMy WebLinkAbout0438 . . _ .
260528
E3~ca~~~~ic~~ o~ ~3o~~~c~le ~~d Cifi~~nsh~~
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'I'O Tf IE STATE AND COUNTY TAX ASSCSSOR, ~
. L~ ?~S' : P_ _ COUNTl'; FLORIDA: - ' - • . ~ ,
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This is my cieclaration of Domicile ancl Citize~tsi~ip in ilie State ot Florida that I am filing this day in
accorda~ice, and in conformity with Section 222.17~ Florida Statutes.
1 was formerly a legal resident of ~e~' 1- : s~ 1'f L~~~'rn ~ and I
c"~ ~ ~ ~ ~CiIY~ (Statej
resided at =~o ~ e . However, I have changed my domicile to
(St~eet and Numbe~j
and am and have been a bona fide resident of the Siate af Fiorida since T~ day of
1'
, t9~~., and 1 reside at _~d 17 ~
. (~~~e~ , , (Street and Humbe~)
i'J . County, Florida,
(acr)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. .
(Insert here any pertinent facts, such u sale oi property or businas, o? relinquishment oi emplorment at former
domicile. removal oi (amily to new domicile. purcAase of home. ete.) -
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Applying for homestead . . . .
~ Entering children in school :
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ST~LUC E COUN1r FLA. ~ '
F~CEn ~p~TRAS - -
C.E?.R C;::CUIT COURT '
PFfr,u~ yr: ~;c~~~~ , _ ~
~ Auc 6 IG 33 ~M'1
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! I FtJRTHER CERTIFY that I will register at my local address when the registration books reopen, and
comply with all otlier requirements of a legal resident of this State.
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~ I FURTHER CERTIFY that 1 have no intention to return to my former domicile, and I intend to remain in
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" ° ' , County,
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Florida,.pe~{nanentlyr=.` tc~'r~
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Qfr?:1o~an '~,ubsci-ibcd bcfore mc this 6 day of
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i A. D. 19~. '
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~ ItOGER PO TRAS, CLCRK CIRCUIT COURT
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By D.C gn;;~ ~a~; .
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