HomeMy WebLinkAbout0607 ,
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Dec~~ra~~Qn a~ i~c~~~ic~~~ Ci~i~~r~shi ~
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TO TNE STATE AND COUNTY TAX ASSESSOR, ~ ~
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Sf .~~c i e COUNTY; FLOKIDA: ~
This is my deciaration of Domicile .and Citizcnship in the State of Florida that 1 am filing this day in
accordance, and in conPormity with Section 222.17, Florida Statutes.
1 was formerly a tegai resident of e P_~? , • and I
(Citr) (State)
resided at ~~T • P~'= r~ o~R e~~ , However, I have changed my domicile to
esaeet .na N~mbe~ _
and am and have becn a bona Cde resident of the State of Florida since ~ day of
, 19_~., and I reside at So ~C~On' .~('~i~~l e
~ (Street and Number)
l~ei r~e . _ County, Florida,
(cxir)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
af Florida. ~ .
(lnsert hne aay pertinent futs, sucA ss sale ot prope~ty or businas. or reli~quishment ot employment at forma
do~aic~e, temovai ot fimily to new domicile~ purchue oi home. ete.)
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Applying for hoff~estead . . . -
~ Entering children in school :
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F1tED A4L~ P.ECORDEp •
• ST.lUC1E ~OUNTY flA. -
ROC~f~ +';~TRAS _ ~ •
CIERK ~CJtt COURT
P.F~r,3~ :~ED . .
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~ I FURTNER CERTIFY that I will register at my local address when ihe registration books reopen, and
~ comply with all other requirements of a legat resident of this State.
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; I FURTHCR CERTIFY that 1 have no intention to return to my former domicile, and I ir.tend to remain in
~ ~~~'`'c- , County,
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Fjvtid~, P~l7p~Gntly. (Cier)
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; ~ ~ . - ~ 1 - = -.'.r (Name) S
! A ,rr,?'.tr-..--` : Q . t
k , ~ , p _ ~ ~ . r• : • //.~/j ( Y C~C~ni~ 4f~/ ~
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~ Sworn.~q;.~3Ubscribed beforc mc this ~ day of ~
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~ A.D. I 9~3 :
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; ROGER PO S, CLERK CIRCUIT COURT
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` By a.~-~c.~-e/ D . C .
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