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I ~ij\ 1'1 PArI14U
Dee oration of .Domicile and Citizenship
~T, LUCIE C8liNiY, rlA.
TO THE STATE AND COUNTY TAX A..c-.seSSOR.
St.Lucie
- --- - ~ --- - -
_ COUNTY. flORIDA:
and
This i~ my declaration of DomiciH, and CitizenshIp in the State of Florida that I am filing this day in accordance.
in conformity with Chapter 222. Section 222.17. Florida Statutes,
Lexinp;ton
Ientucky
I was formerly a legal resident of
-
(City)
(S1.te)
and I resided at
2026 Rainbow Road
However. I have changed my domicile
(SI,.., .nd Number)
to ard am and have been a bona fide resident of the State of Florida since
H~th
day of
P:tlAA~ August
6~and I reside at
501 Holly Ave,
. 19
(Slr..t .nd Number)
Fort Pierce
St.Lueie
County. Florida.
(Cily)
and this statement is to be taken a\ my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(I".... ..... .ny perli.....t feet!, .uch .. ..I. of property Of blni...... Of ,.Iinqu'ohment of employmenl .1 for...., domicile,
,etl'OY.1 of f .mily 10 new domicile. pure"'... of ",-, etc.) .
E.ntering Andre\'! Robert Venters in the tlm 4th p-;rade
" Jane Hhea Venters in the 2nd ,~~ade
~7704
FILED AND RECORDED
I '
IN -I7~ld:~_.!~(j _~OJK
I%! AUG ~5 rr I: 59
f"'I'!~ -- "l"""'.--.... r - _. '1'".'
1.,~'l#LJ\ i Ut' 1..-...... ..- t
Sf. LUCIE COUNTY. flGi\wA
",/ ('LU~~/ 1":
........
I FURTHER CERTIFY that I will register at my local address when the registration books reopen. ar.d comply with
all 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 in'end to remain in_
Ft.Ficrce
permanently.
St.Luf'ie
County. Florida.
(Cityl
/
/J ~~ '-_'- ~'~Lv.-~
(Ni"M)
Mrs. Bonnie J Venters
(Add,...)
Sworn to and subscribed before me this
", \.: . "
, . "J
- :- .-<14'" of -'.
('\ . ~ . ,
_ (, ..." '. r '
. 19
.-)
-
ROGER POITRAS. ClERK CIRCUIT COURT
.. &.. ..
Notary Public
. I)
~~ .:1
Elf
("~ I.. "
... '-Jo
. , ) , .. ': .. ) .: - .
D.C:': "My .Comr'l;\i$sfQn expires
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(To 1M .......... ito ct....li..te ..... ori.i.... f.'it4 with CIeR"Circ,..it C_. A.... ......11.... with 'ex A_....)
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