HomeMy WebLinkAbout1735 ~
Declaration of ~f~~~:cile ~nd Ci~tiz~nst~p
TO THE STATE AND COUNTY TAX ASSESSOR, ,?~sc~,~ '
,~~t~~.~ '
COUNTY, FLORInA: a
. ;
,
'i71is is my decl~ration of Domicile and Citizensliip in the State of Florida that I am Giing this day in ;
,
accordance, and in conformity with Section 222.17, Florida Statutes. ~
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1 was formerly a legal resident of N ~ , NE•~ yURK and 1
'tr) (suee)
resided at 7~G~F ~~N~ . However, I have changed my domicile to
(Street sad Number)
and am and have been a bona fide resident of the State of Florida since S~ day of
i
c~v y , 19
7~ y and I reside at ~ ~ 2 L' ~~~'AR~4AID~4 ~2~ JE _
- (Street ~ad Numbe~)
F% C E _ S~. s.. t~C i
C Couaty, Florida,
(a~r) -
and this statement is ta be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. .
RE~IIRC ~~,u!) so~t~ NC~,•~ yoRK h~M~ ~,«.c{ /'v~rr~ils~V /~of/I_ I^/ Fi /~/ERCF_
(lnsert Aete aay pertinent tsets, such u sale of propertr or business. or ~c:inquishment ot employment st tormet
dpmttae; remoral of familr to new domicJe, purchase of home. ett.)
.
Applying for homestead y~~ ,
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Entering children in school : lvoti'~
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~ I FURTHER CERTIFY that I wiit register at my lacal addmss when the registration baoks reopen, and
comply with all other requirements of a legal r~sident of this State. - ;
t FURTHER CERTIFY that I have no intention to return to my former don~icile, and I intend to remain in
, .
/~"j. PiFkcE Sr L uc i F connty,_
,
Florida, permanently. ~~'t'~ •
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Rp~ ~~~~~IERK CIRCU COURT U R~1~ PAGE~7J5
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