HomeMy WebLinkAbout1763 D~ciaration of Domicile and Citise~ship
9
TO THE STATE AND COUNTY TAX ASSESSOR, 1[~880b`
51. IUCIE COUNTY, FlORiOA:
This is my declaration of Oomicile and Citizenship in the State of Flo~ida that I am filing this dsy i~ aocordante and
in conformity with Chapter 222, Section 222.17, Flo~ida Statutes.
I was formerly a legal ~esident of $1_ Centro _ _ CalifmOllla _
(Ciy) (State)
Bldg 3042, Apt 1, ;
and 1 resided at SU~Ply Dept NARF However I have changed my domitile ~
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 27_ day of
September b6 1914 Fulton Drive
_ _ , 19 and I reside at
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new dornicile, purchase of home, etc.)
~ntering children in filementary school
F1t.ED AND RECORDE~
ST.RECORO VERN
F D~
;
~ '66 SEP 28 AM g: 37
' i4ssos
~ ROGER P017RAS
~ CLERK CIRCUIT COURT
1 FURTHER CERTIFY that 1 will comply with all other requirements of a legal resident of this State.
1 FURTHER CERTIFY that f have no intention to return to my former domiGle, and I i~tend to remain in FORT
PIERCE, SAINT IUCIE COUNTY, FLORIDA, permanently. '
I
t,, . ~I ~
• 'n ~~11`u ~C~t~ ~
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t ~ . ~ : ' ~ (Name)
_
~ • ~ ~'r;,'
~ ~ ~~.:i; Betty Gifford
- . (Address)
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~ '~~f •~-r-, ,~i:t„~_`~
Sworti'td~and~'s~bscribed before me this 28 day of Setrt em , 19-6.6
ROGER POITRAS
CLERK ~ CUIT COURT Notary Public
By D.C. My Commission expires
(To b~ ~xecuT~d in duplicat~ snd ori~inal ~I~d with Gerlc Circuit Cour~, and duplicat~ with Tax Asssssor.)
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