HomeMy WebLinkAbout1490 ~claration ot OomiQil~ and ~itizenship
~ 16`~490 ~
TO THE STATE ANO COUNTY TAX ASSESSOR, -
Si . 111C1E COUNTY, RQRIDa.
This is my decla~ation of Domicile and Citizenship in the State of Horida that 1 am filin~ this day i~ aaa~dano~ a~d
in confonnily with Chapter 22~. Settion 222.17. Flotids Statut~s.
1 was forme~ly a legal rosident of HO11iDd N~Chigio
(City) (Stete)
arxl I ~esided at BO]C ? NtM R~Ch~0~1d . Howaver 1 haw tha~psd my tbmWl~
(Str~tt and Numbsr)
to and am and have been a bona fide res'~dent of the Stats of }Florida sinos 4th - dsy of ~
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pe~~~ber , 19 67 a~ ~~i~ ~ Gentile Road ;
(Street and Number) ;
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FORT M~CE. SAINT ltlClE COUNTY, RORIDA
and this statament is to be taken as my declaration of citizenship, actual leqal residenoe and domicile in fhe Stats of ~lotid~. ~
i
f pnsert here any pe~tinent facts, such as sale of pro~ty or business, or telinquishment of employm~nt ~
at former domicile, removal of family to new domidla, purchass of home, stc.) i
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Bntering BdMin Henry Terry in the Tth grade
Mho is in the custody of Lillie Jones I?laynor his sister
ANp itEC~R~F~-p'• #
5
~LV ~E CvER~~~ '
RE ~°R0 16249U -
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~oc~a ~o~z ~o~a~ I
K CIRCUIT ~
CLER ~
I FURTHER CHtTIFY that 1 will oompiy with all other requiremenfs of a Ispa! residsnt of this State.
I FURTHER CERTIFY that I have no intention to return to my former domiCjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
..st::.:r = .
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- f..lr~~ ' ~a~~
- i.•~•~ ~~!`{'l~.
~ _ Liliie J nes ~lsynor
_ . _
' ~ ~ - ~
: ~ - - : = (Ad~ress) - '
~ ~ ~ . . . = , ' {t ~ .
Swan`r~.e~c,Cd
u;bsu~bed before me *h~s ilth day ef Dece~ber ~q 67 .
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Ro~~ ~an~?s ;
Ctl!CUR C No*ary Public ~
G~.~t~. ~Z~ i x 'res
gy O.C. My Comm ssiare e pi
(Te b~ ~ioiaiNd iw d~plkah and oei~inal fiNd wi11~ Ci~elc qrari~ Care~, snd d~h will~ Yaoc A+~o~.)
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e~K169 P~E1478