HomeMy WebLinkAbout1866 Deciaraiian of D~n~iciie a~d Citizenstiip ~
TO THE STATE ANt9`~OUNTY TAX ASSESSOR. 148862
Sl. IUCIE COUNTY, FLORIDA:
This is my declarotion of Domicilg and Citizenship in the State of Florida that I am filing this day in aoo~rdante and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of _ NBtiCk r'~BSS.
(City) (State)
and I resided at ~_136_ No rth Ave. , Hcw,ever 1 have changed my domicrile
(St~eet and Number)
to and am and have been a bona fide reside~t of the State of Flo~ida since 2-_bt~1_ day of
September 6b 729 ~o Ind.Kiver Drive
_ , 19--, and I reside at
(Street and Number?
FORT MEACE, SAINT IUCIE COUNTY, RORIDA
and this statement is to be taken as my decla~ation of citizensh+p, actual legal residence end domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or busineu, or relinquishment of employment
at former domicite, removal of family to new domicile, purchase of home, etc.)
Entering child in lst grade - John Edward Smeltzer
~
FILEO AND RECQ_R
ST.aECORO VERIFIED
'S6 SFQ 29 PM 4:37
148862
~ ~pr EH pQITRAS
( CI.ERK CIRCUIT COURT
1 FURTHER CEitTIFY that 1 will oomply witfi all other requirements of a legal resident of this State.
I FURTHER CERTIFY ihat I have no intention to return to my former domitile, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
.:~:r:~;,
n,L~'~:.~.. CO~~ ~
G~: :,v~'.'a~~~'•
' f ~ , (Name)
'.1: ~r~ Q; Barbara L. Cros y
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''f,~,~~`~ "'5worn to and subsc~ibed before me this 29th day of September ~ ~q 66,
ROGER POITRAS
CIRCUIT OURT Notary Public
By~ D.C. My Commission expires
(To b~ ~x~cuhd in dupfiuts snd ori~inal filed with CIKIc G~wit Cou~f, snd duplicst~ witb Tax Ass~uor.)
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