HomeMy WebLinkAbout0588 - - . _ _ ' . ~ _ ~ .
2sos3s
~~c~~~a~~Qn c~~ ~3o,~icile a~d Citizenshcp
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TO TNF STATE AND COUNTY TAX ASSGSSOR, ' - -
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_ COUNTY; FLORtDA:
Ttiis is my dcclaration of Domicile and Citizcnship in the State of Florida that I am filing this day in
accordance, and in conformity with Section 222.17, Florida Statutes.
1 was formetly a legal resident of ~s T/~ o?i ~~.v c ~ ,~f10 ~1P ~ and I
. (~~r) (sesee)
resided at ~'1r TT .4 v e . However, i have changed my domicite to
(St~eet and Numbcr)
and am and have been a bona Gde resident of the State of Florida since J~' ~y ~ a- day of
, 19,~= and 2 reside ai C6 %
(saeec .ne Nu,nber)
7~ ~ c c ~.G ~ c County, Florida,
(ta~r)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. - .
(lnsert here any pertinent fscts~ such as sale ot property or business. or telinquishment ot employment at fotma
domicile, rcmoval of family to new domicile, purcdas~ ot Aoms. etc.) ~
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Applying for homestead . . . ~
~ Entering children~in school : ~ - .
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fI~E~ AND RECORDED ' •
ST.lUC1E COUN?Y FLA. '
ROCEr~ FO~TRAS ' ~
CLERK C~~LUIT COURT
• P.FC4R~l ~ERiFIED -
; Auc 1 11 Zs ~M'73
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' I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and
f comply with all other requirements of a legal resident of this State. -
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~ I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
F '
i ~.2 % ~7 ~ uc.~- , S%. .~u c. e . , CountY.
Florida, permanently. (c+~r)
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w - . ~ , (Address)
:
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~ Swortt~to.~}'~b~diri~cd,bcfore.mc this ~ day of _
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s ROGER POI RAS, CLCRK CIRCUIT COURT
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