HomeMy WebLinkAbout1907 0
Decia~atio~ at Domicite and Citize~ship
~~N~~~
TO THE STATE /0.ND COUNTY ~AX ASSESSOR,
Sl. lUC1E COUNTY, FIORIDA:
This is my declaration of Domicile and C:tize~ship in the State of Florida that 1 am filinq this day in aooo~danos a~d
~n conformity w+th Chapter 222, Sectio~ 222.17, Florida Statutes.
1 was fortnerly a lega! resident of Dothan A18baNa
(City) (State)
and 1 resided at _ 202 N. Park However 1 have d~anged my domitile
(Strest and Numt~er)
to and am and have been a bona fide resident of the State of Florida since 15th day of
November , 19 66 , and I ~eside at 118 S. 20th Street
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORtDA
and this statement is to be taken as my declaration of citizenship, actua) lega) residence and domicile in the State of Horida:
(Insert here a??y pertinent facts, such as sale of properry~ or business, or re(inquishment of employment
at former domicile, ~emoval of family to new domicile, purchase of home, etc.) .
Place Child in Schooi
Debra Kay Brown ? yrs.
. ~
FIIED AIdD RECOROED
ST.F
U~~?~ VERIFIED~~
'u~ ^r~' 12 A.~3 ~ ~ 53 -
lsos93
;t~~:t...•"- •'~}i~[~.~'+CJ .
CLERK CIRCUIT COURT
, 1 RIRTHER CERTIFY that I will oomply with all other requirements of a legal resident of this State.
. 1 FURTHER CERTIFY that I have no intention to retum to my former domicile, and 1 intend to rernain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanentiy. -
.
~ (Name) Ja k M. Byars
.~`~~,'`,'~~)`!iilt~113j~'fi ' ~
C~~~``~ 118 S. 20th Street F
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v~ i'•• :'.~r;, : , t~ Pierce, Fla.
G • _ ~ :
(Address)
. •
_ .;~~^:~~I,~~O.
; 4 . : -W ~ ~ : , s.st Z _
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.
~~p :.~iiv~'~ tp~ i iubscribed before me this 12th da of _ ~~e~ber 66
% a'ti . . ~ Y , 19 .
_ _ :•r .
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, ~ . C~tK~CiitC~U~COtIRT
, Notary PubNc
BY D.C. My Con~mission expires
(To b~ ~c~ in dvplicah and ori~inal fil~d wifh Ciuk Cira~if Court, aed duplicate witi~ Tsx I.~ssor.)
aooK 161 Pa~ 1G 5
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