HomeMy WebLinkAbout1714 Deci~ration ot Domicile and Citizenship ~
145353
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FLORI~A:
This is my declaration of Uomicile and Citize~ship in tFie State of Flo~ida that I am filing this dsy in aoootdante And
in confo~mity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal ~es~der~t of _Caruthersville Missouri _
(City) (Staro)
.
202 W. lOth ~treet
and 1 resided at However I have chsnged my domidle
(Street and Numbe~)
to a~ am and have been a bona fide resident of the State of Florida s~nce 12th day of
_ M8~_ ~ ~q 66, and I reside at 507 Gardenia Ave.
(Sfreet s~d Number)
FORT PIERCE, SAINT IUCIE COUNTY, RORI~A
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicila in the State of Horida.
(Insert here any pertinent fads, such as sale of p~operty or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Richard Charles Rushing - 9 yrs. old
To Place Child in School
~ J~~?~~ aN ~
- R~CORpFQ {
~ B~OK
, 66 ~f
~Y ~ s
~ 14sp"' z ~ ~ 8
~3
PC17
s F ~~~p~ ~~~NT ~RK
.ft~co~ V~ ~oa Y.
I~
#
1 FURTHER CERTIFY that 1 will comply with all other requirements of a leflal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domiGle, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
(Name) Mrs. Charles hing
~~'"~st~: - SO7 Gardenis Ave., Ft. Pierce,Fla.
. !/jf.
' . vr."'.."'~ (I U~ddress)
• , ; : ~ ~1~?'~'~ C ~~•.Aj~ .
• jq~J•,.~t~, Gi ;
_ `.C3'~,'E,~'°':{~('a c''. Z ,
i~ ,3. ~
' r„j~ t~d~~jbs~cjt~cd before me this t6th day of ~Y ~q 66,
: a , p.f1s . p. g .
i Wie * .
I~~S. ~ ~ ~ ~ ~ ~;'~7'%
<wa,. ' ~ ~ : y ~ ~ ` -s"
'.~~•~i~'~± ^~.~.3~ f{ ~ 'y s
~
~ .'J R~~~~CpuRT Notary Public
_ ;t~C~~~ . . ,
gy D.C. , My Gommission expires
fr' .
(To b~ ~acuhd i~ duplicah and ori~inal fi{~d wifl~ Cl~rlc Cirarit Cou~f, and dupl~e~h with Tsx Aaa~or.)
~ooK ~.45 51,2
:
_ . - _ - . - - -
. ~
~
~
_ _ _