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Oeclaratio~ ot Do~nicite a~d Citisenship
TO THE STATE AND COUNTY TAX ASSESSOR. 14`~~83
Si. LUCIE COUNTY, FIORIDA:
This is my dacla~ation of Domicile and Citizenship in the State of Florida that I am filinfl this day in acaords~ce snd
in oonformiy with Chapte~ 222, Section 222.17, Florida Statutes.
I was formerly a legal reside~t of FO1kStOQ GeOr¢ia
(City) (State)
and 1 resided at BOx 531 _ However I have changed my domidle
, (STreet and Numbe~)
to and am and have been a bona fide ~esident of the State of Florida since 25th day of
August 66 2510 De1.Aye.,
, 19 , and 1 reside at
(Street and Number)
FORT MERCE, SAINT LUCIE COUNTY, RORIDA ~
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
pnsert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bntering Debra J Zanders in the 6th grade
" ,Julie in the 2n~ grade
F11.~0 1?ND RE6Q~0~ '
s~. LUCOR~ OU RIF E~. . .
REC
! '66 Au~ 6 ~5
~ ~4'7J
~ ~ ~~o~TRC~s
R~ ~E COURT
CLERK CIRCUIY
~
I RJRTHER CERTIFY that 1 will oomply with all other requiremenri of a leyal resident of thia State.
I FURTHER CERTIFY that I have no intention to retum to my former domitile, and I intend to remain in FORT
P{ERCEt,$AIA17;~11~1E COUNTY, FLORIDA, permanently.
. ;
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•'3 ~vi,~~ii_~..
~y' M.~•
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_ JeNeli Zan rs
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, (Address)
-.t'~/T t w ~ JfJ'
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~ Swcrn to and subsuibed before me this 26th day of AugUSt ~ 19 66
R POITRAS
CIRCUIT CO Notary Public
~ mi ' n x i~es
gy D.C. My Com u~o e p
(To b~ ~x~cutad in dupl~eat~ and ori~insl fil~d with d~eic Circuh Cou~f, and duplicat~ with Tau At~sso?.)
soac 153 39~
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