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D~cl~uratioe of Domiall ~r~d Citts p
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TO THE STATE ANO C~OIJNTY TAX ASSESSOR,
' S?. LIKIE COUNTY. fLOR1~A: ~ • .
Thk ia my d~duation of Domidle and Citir~?ship i~ th~ St~U of Norida th~t 1 am Nli~q this diy in ~oaordsna and •
in oonformity with C~aptK 4Z~. Se~ctton Z2Z. t f, Fbrida Statul~t. • ~ .
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~ was fama~r a ~.p.~ retid~nr of St. l~dary's • ' Georgia
, (City) . (St~h~
~ and 1~W~d at 105 SeaGrove ~ How~w?1 haw chan~d my domWl~ :
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b u~d am ~nd have beM a ba~a fkl~ r~sideM of th~ Stat~ of Norida ~ir~as Sth ~y ~
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Januar~ ~~q 65 u ~3 3221 So Dixie ( Dick •s Mobile .
- t5tn.t anci NumbK)
fORT S~AINT LYCIE ~OUNT1f, RORIDA . ,
and this :tatem~nt i: to bs taken a~ my dedantbn af citlz~nihip, actual Ipal r~id~na and domidl~ 1~ th~ Stat~ af Horidi.
(Insert hsre an rtinsM fads, wd~ as s~le of \
Y Pe ProP~Y or busin~u, or nllnquisM~v b~ ~mpicym~nt ~
at formsr domkils, romoval of family b new domkile. purdus~ of hon?~, Mt.) ;
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Enterrng Glenda Smith in the 7th grade
" Sandra Smith in the Sth
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" Donald in the 2nd grade '
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~ ~ 1965 JAN I 9 AM I1: 09 . ~:r~ ,
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' ~ ROGER POITRAS,CIERK ~ •1•':'•~``y: F
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~ St. IUCIE COUNTY. FlOR10 ~ ••.,,.~,1~~~....•~' ~
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1 RJRTHER CE~tTIFlf tfi~t 1 Will aompiy With all aaber nqulnn~ls of a{psl ~{d~nt of tf~it Shf~.
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1 FlJRTHER CERTlfY thit 1 have ~o Intention to return to my~ forrr~ domWl~, and 1 iM~d to nn~l~ in fORT ~
PIERCE, SAINT lUC1E ~OUNTY, fLORiDA,.permanently. i
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: ` - - i . Portia Ann O~Berr~ . !
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1a and wb~lb.d bs~or. m. thfs 19th Januar~ 19 6s
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RO~ ~OITRA~
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~ Notary Pubik
8f? r' ~ D.C. AAy Gort~mluion ~xpi~ .
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_ (~i M~ M d~licN~ aMi ~ioM~l flW wiN~ CM~k Ci~wM Cw~t, aNi i~iaM ~rM~ Tatc Aw~w~r~
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