HomeMy WebLinkAbout2670 Dectaration of L?~~a:c~te dnc~ Citiz~n~h~p
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SSESSOR ~~~b ~
'Pp THE STA'fE AND COUNTY TAX A . ,
~ COUNTY, FLORIDA: ,
Thi~ is my decla~atio~n of Domicile and Citizenship in the Stata of Florida that I am filing this day in '
acoordance, and in conCormity with Section 222.17, Flo~da Statutes. .
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I was formerly a legat resident of ~y ~ , and 1
~ (Ctts) (ststs)
r~.sided at - C' . Howcver, 1 have changed my domicile to
(Strest a.d N~mber)
and am and have br~n a bona fide resident of the State of Florida since day of
, 19~ and I reside at 9a -
(su«~.aa N~m~r)
~ ~ ~~~.,r,0, ' ~ - ~ - County, Florida,
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and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. ~ .
(taxtt I~ue ae~ pertiaewt hcts. sncb at s~le of pwperty or b~siac~• a n~'p9uis6meat of easplormeut at former _
apaiicie: reso+al ot iwiilr to aew domieile. p+~rd~~e ot Aome, ett.)
Apglying for homestead
Entering children in school :
_
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_ d I ~ _ iT `UC~E COtlM~'f1 L~
~ ROCER *41TRA~ I,
G'U CiERR C1RCUtT COYRT 'i
C!/N^-~~- • . RECORO VE~IFiEO
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I FtJRTHER CERTIFY that I will register at my local address when the registration books reopen, and
comply with alI other requirements of a legal resident of this State. -
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
o S~ ~u,c.c.~ • , CountY.-
~~ar~ ~
-~Yl~i~'E~tZ
Florida, perman~: _ ~
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`~or~i~o~and w~ ~ fore me this day of
,,~i~~
j` ~ ~N.._, i .
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-
`-j. _ ' A.D. l9_~_
_ r K~ ~~r:~
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ROGER POITRAS, CIERK CIRCUIT OURT ~ d~~ '
By , C G C~v L.C
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