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Citizenship
1t) PACE 544
Dedaration..~lu~if,it~Hq~d
. iI.
IW:JK
TO THE STATE AND COUNTY TAX ASSESSOR,
_ S.t,..a Luci a ____ _ _COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in tho State of Florida that I am filing this day in accordance,
and in conformity with Chapter 222. Section 222.17, Florida Statutes,
I was-formerly a legal residen' of
Detroit
(CIty)
Michi1!an
(SI'a1.)
and I resided at
lS04I!Hoover Road .-
(Str.., end Number)
However, I have changed my domitile
to and am and have been a bona fide resident of the S~.te of Florida since 17th
day of
June
, 19q1 , and' I reside at
507 Garden~a_!venue
(SIr.., .nd Number)
Fort Pierce
(City)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. .
St. Lucie
County, Florida,
(I......, her. .ny petti.....' f_, wch .. ..!. of property M bus...... Of r.llnqu..........' of ......Ioymenr .1 tor..... domki!.,
.....-.1 of f.mily to new domIcI!., purcJ\Me of ~, etc.)
Entering two children in public school:
Letha Susan Tolbert in 9th Grade
Connie Ruth Tolbert in 5th Grade
-
....
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FILEO AND RECOROED " '::, , .. .' '.':-'
ILl ~. OOK I;; t '.: '. 'y} ~,:
rt ....-. >I ~ .....
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\QC:' AUG 2""> ~? \0: 37 ':-;":.~"fl",'.? :
...., '~:'~'l';;::'~
;;. '.: v __ 1 ~ ;1 ~ ~ T i\:" ~. ~lr~,:\
S I. LUCIE COUNTY, fLO~5
I FURTHER CERTIFY that I will 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 tMt I h.ve no intention to return to my former domicile. and I Intend to remain in_ - - -- -
_ _ _ ._ _~~!_~~_C_~~---- __ ___ _ _ County, Florida,
Pan Pierce
- _~-+-__ _____ ___I ________________
-- --; \ \ r-C'..., . (Cityl
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W1111aa ~olbert
507 Gardenia Avenue, Fort Pierce
_ __ . _____ ___n________. ___n__ ----- - -F-lorida
(Adchw)
Sworn to .nd subscribed before me this.
22n..4____ _ day of __n_..ll~~tt------------------, 19_._9~_
_ ~_d_________________________________________
----------------------------------------
ROGER POITRAS. ~RCUI~ COURt
By -'Y?)~-t.--~------- D.C.
(fe .. ---' .. ...... ... ........ ..... ... aM c:a.WIt c-t, ... ...... ... T. ~
Notary Public
My Commiuion expires -----------.---.-----------
.~aD, FT. ~I&.a&