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Declaratio~ ot Domicile and Citizenship
147`952
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FtORi[~A: '
This is my declaration of Uomicile and Citizenship in the State of Florida that I am tiling this day in acoordance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a iegai ~es~der,r of Dexter Missouri _
(City) (StAte)
and 1 resided at ROUte #1~ BOx 7 However I have changed my domiute
(Street and Number)
to and am and have been a bona fide resident of the State of Ftorida since _____19th___ day of
Au~gust ~q 66~ and 1 reside at ShamroCk Village - ADt. A-12
(Street a~d Number3
FORT PlFRCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citize~ship, actuat legal residence and domicile in the State of Horida.
(Ins~:t here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of famity to new domicite, purchase of home, ett.) ~
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TO BNTER CHILD IN SCHOOL
Victoria Wanda Varela 10 yes.
FILEO AND RECORDED
gT, l.UC1E CUUN?Y. F~-A•
~,~C~ar~ RIFIED
'~6 2S P~1 : 08 .
14'7~52
:G~F„ ifj„ri-~
CLERK ClRCU1T CUURT _
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I FURTHER CERTIFY ihat I wi(I comply with ail other requirements of a legal res+dent of this State. i
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~ I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT ;
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r PIERCE, SAtNT LUCIE COUNTY, FLORIDA, permanently_ .
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~ . (Name) Betty DeVarela ~
t ~t?:::?:t~.:;;;~., l
~ `v~il ~C~~,:;,; " ~
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amrock Vi11a e-A t.
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•=.*~vrbr'irte
a~id subsuibed before me this 25th day of AUguSt ~q 66
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; ~ : #tS~ER P~ITR14S
~ CIRCUIT C URT Notary Public
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~ By D.C. My Commission expires
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(To b~ executed in duplicsfs and orisinsl filed CI Grcuit Court, snd dupliat~ witfi Tax Ass~ssor.) ~
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