HomeMy WebLinkAbout1394 - - . . . . - . y~l.. ~
~
,
D~clara~~on af ~3or~ic~te ~r~d Ci~iz~r~sh~~ 6-~~'s3
.
"1~0 ~'tiC STATE I~lD COUNTY TAX ASSCSSOR, ~
w
o , ~ ,
_ - COUNTY; FLORIDA:
This is my dcclaration ot Domicile and Citizenship in thc State of Florida that I am Cling this day in
accordance, and in conformity with Section 222.17, Florida Statutes. ~ ,
~ e o
1 was formeriy a legal resident of , nd 1
~ Ciir) (Sate)
resided at vi cQ,~Q. F~~ Howcver, I have changed my domicile to
- (St~eet and Number)
and am and have been a bona Cde residcnt of the State of Florida since a N~ day of
~ , 19_1~., and 1 reside at
• ~ ~ ^ J ~Q ;Street aad N Mr)
TY lt t F~ c~T ~ 1 t I~~ County, Florida,
_ ~~ir~
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 fsets. sucA ss sale ot pwperty or business. or telinquishment ot emplormeat ~t twmer ~
domic~lq. temoval of tamilr to new domicile. purchsse of home, ete.)
Applying for homestead . . .
Entering children in school :
. ~ya~
~ ~'l- .
- FILED A+iD. RECOROED
SL[.UCIE COUNTY FLA. C
~ • - RGCEF P~?TRAS
- ~ CLERK CinvU1T COURT ,
RF~ORa YEF.IiI£D~ - . .
i .
~ ~ Au~ 13 I i i2 AN'73
E
I
~
~
~
~
~ - 261253
I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and
comply with all other requirements of a legal resident of this State.
I FURTH CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
~ fZ-~-~_~ o , CountY.
.
~ Florida, ncrm~~~ncty:.. ~ ~ci~r) -
~ •
~ : ~ : ; • .
••,~a`~ _ + ` ' ~ ~ ~
~ .
:!1. tr.
~ l f ' y , • ~ ~
x ~ ~ - ~ t (Abme) .
~ :~.:4: , -,i • : 1~ .
.,..f`;. • .
. . ~ _ • : ~ - (Addtes.s)
~ •r~"_~J•''•ti'°'t'~~~ • - ~
Sworn to and subscribed betore me this ~ day of
~ .
- - A. D. 19~ ~
~
~ 1tOG~R POITRAS, CIERK CI CUIT COURT
~ I?Y D.~ ~ ~217 ~~13&9
. .
~ Z ~ _ ~
'c~_ f f v 4'
~ie'..1?; a .,.~x..s~. _e _ _ , . . _ .'W''{ ~ ~.v,~