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Deel~~~~~ CitizeNhip
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TO THE ::iTATE AND COUNTY TAX ASSESSOR,
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ST, LLCIE COUNTY, FLORIDA:
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This is nlf decht.ratlon of Domicile and Citben5hlp In t~e State of Florida that I am filinIC this day in ao:cordance
and In conf(\rmil)' with Chapter 222, Sect!l:>n 222,17. Florida statutes.
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South CaroliLo
State
I W3S fot'merly a legal resident o:l
Mayesvil18t '
(CI y)
Rt.44
lStreet and Num~r)
to 'lid I\ln and have been a bona fide resident of the Slate of Florida slnee
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However, I have ch~nged my domicile
an.1 I reblded at ~
1st
day of
June
19 63
lO? N. 10th St.
. and I resids 'at
FORT PIERCE, SAINT L\lCIR COUNTY, FLORIDA,
(Steet and Num~r)
Gen Del. Post (;ffi.ce
lInd this statement ill to be taken as my declaration of c:iti&3Tlship, actual legal residence ar..d domicile in the State of Fbrid&.
(Insert here any pertinent facts, such as IIale of property or b~.ineH, or reHllquishment of employment
at tormer dorn;clle, removal of famUy to new dc;micle, purchase of home, etc.)
Entering 2 children in school
Mary Louis~ '.-;i160n
9 yrs
8 yrs
113214.
Jim '.'ii180n
FILED AND RECORDED
W 0ffkW &ew4- nOOK
1963 fIB 15 PM 12: 00
ROGER POITRAS, CL::RK
Sf. LUCIE COUNT'f, flOj? t..-;J
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I FURTH~ CERTIFY that i wiJI r&glater at my loea1
addru. when tb~ re~JtraUon books reopen, and tOrlply
with Illl other requirements of a icltsl re.ider.t of this State.
I FUR'1'HER CERTIFY thst I have no Intenti071 to return to my former domiclJ-e, and I int(jnd to l'c!!l8in in
FORT PIERCE, SAINT LUCIE COUNTY. FLORIDA, permanentl1.
(IC~r.{G l~.0-CJ.
(Natn4l>
Rachel Wilson
;.<'~~:~) t!,. '!~A"~
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, {l',-~~.Y;. SWOfl 'to,,~ Jifr!:'crite..i bi!fore me thb
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... ...~ IJ~~.(.~B'...:~ ','.., ': ~ ~;~,]; l~~COURT
l~,,'1
BL))z2P~ ~
(Address)
15th day of Ee brua~!_.
1963
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N~W7 Publlo
(To ~ ex~uted
D.C, M1 CommLuioD apir.l
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llHd wtUt ~ Clmdt CottIt. aiM lllaplkate with Tu ~)
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