HomeMy WebLinkAbout1773 Qeclar~~EOn of ~or~:~c~le and Citiz~nst~~p
TO THE STATE AND COUNTY TAX ASSESSOR, ~~is'v~4
} ~ c ~ ~ ~ COUNTY,,FLORIDA: , '
This is my deciaration of Domiciic~ and Citizensltiip in the Statc of Florida that 1 am Cling this day in ~
accordance, and in conformity with Section 222.17, Florida Statutes.
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1 was formcrly a legal resident of ~~~~t % ~-S and I '
~ (cit~) (stat:) ,
resided st S" c~ . However, I have changed my domicile to ;
(Street aod Num~)
and am and have been a bona Cde resident of the State of Ftorida since ~ day of ;
.
• ~ ~ ~ ~ 19~ and I reside at cg~ ~J %-t " ~ ~r ~ ' ' ~ UP/' -
f ' .~-~c.pa N~me~)
~'i C ~t~ _ ~~t- ~c? r , County, Florida,
(Cti~r)
and ti~is statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. .
(Insett hece any pertine~t tacts, such as sale of property or business, ot relinquisAment ot employment at tormer
domic0e; remoral of hmilr to new domicJe, purchsse ot home. etc.)
Applying for homestead
Fntering children in school : ,C~ n ~ y ~ ~ ~J ~
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- i, ti~~• ~l~ lzs~L~.1e ~5,.
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i FIIED ~k~ ~cceRpE~ Vl~~
~ sT. luc~E cuuNTr Fu. ~
ROCE=s F~ITR4c ~
~ ClE=lc :;~',~ilIT COURT
REC^^~ :E'~.F'~l'
,J~. i I 2 Za PN'1~1
?!g#;~r,~ -
I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and
co~nply with all othes requirements of a lega! resident of ihis State. -
~ 1 FURTHER CERTII=Y that I have no intention to rcturn to my former d:•micile, and I intend to remain in
~ 1
~ / /
`i ' ~ C L. 4~ Ci
'~f > • t c F~ - , - , CountY, -
Florida, permanently. «'t''~
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02~. ~rc im- y~~
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Sw~cn ~ nd subs~d beforc mc this day of
~ A.D. 19 7c~ -
~ .....•t .
P
ROGER 1'OITRAS, CIERK CIR UIT COURT -
ny , D . C 600K PAGE 1? ~3 _ " • -
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