HomeMy WebLinkAbout1895 Declaration of Qo~t:ci~s and C~tiz~nsh~p
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TO 7HE STATE AND COUNTY TAX ASSESSOR, '
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L.sL~~__ COUNTY, FL.ORIDA: - , '
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7l~t b my declaration ot Domicile snd CStjunship ln tha Stato of FloridA that I am tillr~ U~Is day in
aooordanoa, and ~ oonformity with Section 22~:17, Fiorida Statutes.
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I Mnet formedy ~ legai raida~t of .~Y1~~Q- ~ ~~n and 1 ~
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n~ided st ~f~=~t:S~~. . . How~aver, I hava cha~ed my domtcile to
~hs~t aM Nwsea)
snd aat ~aad have been s bona tlde raident of the Stata of Flaida since day of
1~~ . , 19~., and 1 t~sida at~ ~c
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~rc.e.. L~:Q ~s- ~ County, ~'lorida,
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and this atatement is to be taken as my declsration of citizenship, actual k~al residenca and domic~e In the State~ -
of Florida ' .
(ireee I~ae a.f oKtMewt tsea. s~h .s sd. d p~ooertr ot eosi~w, ar ~WqriA~.e o~..plo~rw~e.e ~t tor.Nt
~O~kM; taso+al ot f~wilr W ww domitiM. Vurda~ ot ~oa~~. ~te.) . .
Applying for hwnestead - ~
VEntering children in school : ' ~ - . ' ~
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~ ' ~ iT.lUC1E COUNT~ fL4.
aocEa portiu?= .
C~ERK C.~CUIT COURT ~ ' - r ' ' '
~ - REGORD VERtF1Ep.~~,,, . .
' ~ ' N~r i3 3 0o PM'7 . -
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I FURTHER CERTIFY that 1 wiU register at my local address when the registration books reopen, and
comply with all other requirements of a legal resident of this State. .
I FURTHER CERTIFY ihat 1 have no. intention to return to my former domicile, and i i~tend to remain in
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Florida, pern~anendy. ~ckr) . .
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Sworn? ~:~ii~ciibed before me this ~ dsy ot .
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A.D. 19~.~ .
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ROGEx ITRAS ~ CLERK CIRCUIT COURT • ' . ' ~ ~ . . ~
BY ~"o .C 6~c~ P~lif~~ • ~ _ -
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