HomeMy WebLinkAbout0657- ~clara~io>;~ Qf I~arruicile and ~itizenahi~
9~RK 49 FAtf ~cl~
To THE STaTE wND Gt~UNTY Tax A9rSES.~3$,
3T. LuCIE COUNTY, FLGRIDA: ST•.LUCiE i.~UNtY. ~l.A.
This is rt~y declaration of Drsnfcila •and Citlaenship !A the State of Florida that I am filing thL day in accordance
and in conformity with Chapter 72Z, 3action Zrl.i?, Florida Statutes.
I was formerly a legal resident of - Jaok9onv111e North Carolina
[CitYJ - State
and I resided at ~urtiEt 4 Ati]c 245 However, I have changed my domicile
[Street and Plumber]
to and am and have been s bona fide resident of the State o! Florida since ___._~~- day of
NOVBIDbe:r 19_62 and I reside at 538 3, Ddarket Avenue
[Street and :h:mber]
FORT PIERCE, SAINT IaUCIE COUNTY, FIARIDA,
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
[Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc•]
Entering u~ieh+ilel Alan Dixon in 2nd Grade
li_0~42
_ _ IN
~~; .~_;;`,~ ~j ';~ ~. 1962 NOV 14 AM 9: 17
'``' = ~' ~~ ~~ '~ ~ ~ ~ '~'~~~`-`~_ - ROGER POITRAS. CIERK
•~ ~ ~~ ~; ~ - ,.~' St. LUC1E C4UNt'!, FtORIDA(I
.,
I FURTHI:.R CERTIFY that I will regiRter at my local address when the registration books reopen, and comply
with all other requirements of a legal resident of this State.
I F'TIItTHER CERTIFY that I have no intention to return •to my former domicile, and I intend to remain in
FQ~t'~~. ~`~ i UCIE COUNTX, ,e IARIDA, permanently.
._ , _~
-~ :. • ~•' ., . ~ ._ 2~rs. ~~ry Fouts Dixon
P --
b r [Address]
S~,vorn~•ta •~d,auliscribed before me tl.+~ 14 lay of Nnv amh ~_ ~ lg~_
ROGER POITRAS
CLF,Rii CIRCUI/T COURT
r.,,
IQotary Public
hfy C~mmiseion expires
[To be a~ectited In duplicate and original flied with Clerk Circutt Court, and duyl;cste ivlth Tax :assessor]