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Declaration ot Dort~icile a~d Citizenship
-14'7948
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FLORI~A;
This is my declaration of Oomicile and Citizenship in the State of Florida that ! am fil;ng this day in accordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes. - ~
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I was formerly a (egal resident of -_Y8C011 _ _.__i_^ _ (~S _ _ -
(City) (State)
and I resided at 2 ~ _ Cordel e Av~ . _ _ _ _ _ _ _ _ . However 1 have ~hanged my domiG~e ~
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since ~rd _ _ day of
-~f 19
66 , and I reside at _~'S38 I B8r=8C18ugh 8t. (
(Street and Nu;rh .r?
~
FORT PIERCE, SAINT LUCIE COUNTY, KORIDA ~
and this statement is to be taken as my declaration of citizenship, actual legai residence and domicite in the State of Horida. ~
(Insert he~e any pertinent facts, such as sale of properfy or business, o~ relinquishment of employment
at former domicile, removal of famiiy to new domicile, purchase of home, etc.)
~T ERIHG T1f0 ( 2) CHILDBB~ Ig PUBL IC 3CHOOLB
FllE9 ANB RE
ST. LUCIE COU O~
~ ~F OP.D VERJ
Fj~Ep`^.
DAQID ZYH~ JOBES (11 yrs) a~~z~
SU3AH CHBISTIBS JONES ( g yra ) ~6fi AUG 2S AM : 25
147'~qg
kOGc:h ~-O17RAS
CIERK CtRCUIT COURT
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; I FURTHER CERTIFY that I will compty with all other requirements of a(egal res+dent of this State. ~
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~ I FURTHER CERTIFY that I have no intention to return to my former domiCile, and 1 intend to remain in FORT
E
E PIERCE, SAINT LUCIE COUNTY, FLORlDA, permanently.
P
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ip
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; (Name)
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' Pearl dune Jonee #
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' Swo;~~and subscribed before me this 25~ day of A1xBuBt , 1966 , #
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~ ~ - . ~p~ER POt ~
~ ~ ~ ~ ~GLERK CUI OURT Notary Public
~ By D.C. My Commission expires
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` (To bs ex in dupliwte snd original filed with Clerk Grcuit Court, snd dupliate with Tax Assessor.) ~
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; - ~o~i53 347
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