HomeMy WebLinkAbout17013~i . 3 4~b
Declaration o~T't1i~?~~~b~~' Citizenship
TO TS8 STATIC .AND QOUNTY TAY ASSSSi30R,
Saint I,t1oi• COUI~'1'lf. lrLOBIDA:
This is my d~rstion of Domicile and Cfti:~ahip in the State of P7orida that I am lUing this day in
accordance, and in coniortoity with Chapter 222, Section 222.1?. Florida Statutes.
I was formerly a legal resident of_-____Pit~~i~hutg----_-- --~------__j~`-~_'4~__--
.r•,.. ~...-.-.
and I resided at___---.341-----YOQ~~- l~~__.-•-----------__--_- -- ---___-. Flowever, I have chanted my domicile
(Street sad Nnmbr) -- -
to and am and have been a bona llde resident of the State of Florida aince__.dth____________________________day of
-----------February _~----____-, 19 61, and I Bide at____~Il~Sntrad<__Jie~,..._Pnrt_a~~.Idigi~
(Settwt and Nambar)
----loTt__ P{ 4n_-- -- --, -_-_-- St .I.ne~____--__-_ ___County, Florida,
(Cib) -
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in
the State of Florida.
(Insert flare anp pertinent facts, sncb as sale of ~roD°~nrehaNbnsi ~. or~r;linquisLment ao< emplormsat et
former domkile. remotal of family to t>•w domiefla. D
$ntering Ronald aoldbeeher in the 8th grade
and Thomas Goldbacher in the 4th grade
~21~3
FLED AND RECORDED
M ~~ 40~JK
IN ~~
ie~.. ~E~ -7 at~~~~'4
Rp LUR--~ Covn~~ ~~#
,,
'' 3:
••:`j e,
r ,
,3 .~ .•
- b.l ,~
. ;. ~ i ,.1` t r,
,-. ~,
~~, ~ ~ ,
I FURTHER CERTIp'Y that I will register at my local address when the registration hooka reopen,
anti coir-pir wiiii ail vtn8i ioyuiac,i,ciato of o ic6al wident^,# t{~i• Qt~to,
I FURTHER CERTIF'i t'nai i have no inicniiuu to tisa;iir„ iti ++iF farmer .',:,mic;lt, a^,d I i:S*.~^.3 *~ `r~°'-^.
• _ Fort Pierce St.Lucie _County, Florida,
------ ----------- --------------
m---------------- --------------------------------------------------- ---------------------------
(cit,~)
permanently.
----- --- ---- -- - ------------------
(Name)
_ >~Sary J. oldbacher
Sworn to and subscribed before me thie_________7__day of
---- ----------February ------+ A. D. 18------.61
~~~--
----- Notary Pablie State a1 Florida at Lase
My Commission ezpirea_____~ ~:___1~. 1984
• ,~:,
.r. Y' ~
t~ ~ _ ,.~
(To be a:eented fn dnpllate and oriSinal flied with Clerk Cixnit C+oart. aed duplicate whit Tas Assaaor)
Boren 6upDh Co.. Plan[ Cltr. DID.
3 ~~ :paw .