HomeMy WebLinkAbout1436 Z86433 ~
Declaration of C~o~:cEle ar~d Cit~zensi~~p
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TO TNC S A COUNTY TAX ASSESSOR,
J,S~- . 1~~.n_,'C. _ COUNTY,,FLORIUA: , . ,
This is my dcclaration oC Domicile and Citi7cnsl~ip in thc Statc of Florida that 1 am filing this day in
acvordance, and in conformity with Section 222.17, Florida Statutes.
i was formerly a legal resident of ~~'-F~ CT r_ e r o:~ _ and I
tCitr) ( te)
1 7?,~_~~, 5~o r~ D r. . However, I have changed my domicile to
resided at . , o
(Street and NumEer)
and am and have been a bona fide resident of the State of Florida since ~ day of
/~'f } C.~ , 19Tf and 1 reside at ~ 7!~ ~ u- ~ n ~ v'e. •
(Smet sne uinber)
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f. c~ r n~ y;~' _ County, Florida,
(a~r)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. _ ,
(lax~t bue snr pertine~t tacts, sucA u sale ot propertr or business, or relinquisAment ot employment at torr:.er
dpmie~e; remova! of family to new domicUe. purchase ot home. ete.)
Applying for homestead
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Entering children in school :
; 7 > 1_
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- FILED RH~ ~+,CUROED
ST_ tUC~i ~pLNTY F~A, .
ROC~R FOtTRAS L
CLE31f C~~CUlT COURt
' • RFCOaR Vrr'.~FlF~ ~
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,1ut. 9 2 4o PH'l~I
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~6433
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I FURTHER CERTIFY that t will register at my local address when the registration books reopen, and
comply with al! other requirements of a legal resident of this State. -
I FURTHER CERTIFY that 1 have no intention to return t~ my former domicile, and i intend to remain in ~
~1~ P r ` , 5 ~ ~ _!r ~ , County, -
Florida, permanentty. - ~ % ' ~
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~ - ' • ~ (Nsme)
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;,r'~, `'3'•'~ 1 > ' `f
i I • (Address)
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~tor~` and-sutiacri~ beforc mc this ~ day of
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c~ • .i~ -
4:~
~ A.D.19~. -
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ROG~~,~.~-.'~Pit~~~~R~AS CIERK CIRCUIT URT • -
IIy ~ t D. C BOOK PACE 1435 - ~
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