HomeMy WebLinkAbout2220 DeCla~atton ot Domicil• and Cltisenship
TO THE STATE AND COUNTY TAX ASSESSOR. ~V~`~v~
Sj . LUCIE GOUNTY, FlOR10A:
This is my declaration of Domicile and Ctize~ship in the Stats of Horida that i am filin~ this day in sooo~danos and
~n conformity with Chapte~ 222, Section 222,17, Florida Statutes. ,
1 was formerly a legal ~esidef,t of Pekin IAdiana
Kiry) (Stets)
and I resided at _._Rt a _ Howevef 1 have chanqed my domic3le
(Street a~d Number)
to and am a~d have been a~ona fide resident of the State of Florida :ince 19th dsy of
_ February , 19 6? and I ~aide at 3503 Ave R
(Sheet and Number)
FORT MERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actval legai ~e:idence and domicile in the Stab of Florida.
(insert here any pe~tinent fa,.-ts, such as safe of propeny or business, or relinquishment of employment
at former domicile, removal af family to new domicite, purchase of home, etc.)
FIlEp AND RECORDEO ~
Bntering children in school ST• ~UCt~ COUN7Y F~q, '
3 rd ~~CO~'p ~~RIFIFp ~
Rachel C, in the zut grade ,6~ F~15293~
R22PM Z:II
AaEa Bdward in the 6th grade
:tpr,`~'
~~PC~i~~
p ~'UttP. ;g
Newell R in the 6th grade C~ERK ~~RCUIT COURT
Hugh Ray Jr in the 8th g~rade
Marshall ~aulette in the lOth grade ~
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_ ~
1 FURTHER CERTIFY that I will aomply with all other ~equirements of a leyat resident of this Stafe.
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I FURTHER CERTIFY that I have no intention to retum to my former domicale, and I intend to remain in FORT {
i
PIERCE, SAtNT LUCIE COUNTY, FLORIDA, permanently. ;
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C.~ ;:gJ :~`~~'~,y? ' ~ ~
- - : ~Q , ~ _ (Name)
- =s~ ~ ; i ~ : - Nellie L. Blankenbaker
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/ ` . ' , • ~ (Address)
''•,,~i~Cf~ '~p•~- i
Sworn to and subscribed before me this 22nd day of Feb. 19 67
,
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~
ROGER POiTRAS ;
,~IC CIRCUIT tOU~'tT _ Notary Public ~
Y '~i`"~ ~~~~~:C~ D.C. M Commission ex ires
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ITo b~ ~x~cuhd in duplkat~ and ai~ieal Rl~d wi1l~ Cl~k qrarif Cou~, and dupliuh with Tax A~or.) ~
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doaxs 4 PA~F2z~.s
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