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D~claratlon ot Oomicfl~ s~d Citi~~nshlp se
TO THE STATE AND GOUNTY TAX ASSESSOR,
Sl. UKIE COUNTY, FIORIDA: ~
Thii is my decla~atio~ of Oomials and Citiz~nship in th~ State of Horida that I~rn fili~p this day in aooonlano~ ~+d
in conforntlly with ChaptK 222. S~ction 222.17. Horida Statut~.
1 was formsrly a Ipal rosident of Yinatoa Alabaua .
. (City~ (Sta»)
and I t~std~d at Rt . 1~ Bo~c 252 my ~~N
(Street and Numb~r)
ro and am and have baen a bona fPds rosident of the State o# Fbrida slnae -~j~r~l 30 day of
19~$_, ar+d 1 raide at Rt. 3, Box 490-1 (
(Str~st and NumbK)
EORT M~f. SAINT UKIE COUNTY. RORqA -
and this staterr~ent is to be take~ as my dedaration of dtinenship, actual lepal residenos a~d domicil~ in the Stst~ of Florlda•
qnse~t hem any pertinent facK, such as ssle of propsrry or business, or relinquishmsnt of employm~nt
at fonne~ domicife, ~~emoval of family to new domicile, purchase of home, Mc.)
Bntering child in school - Diane Bedaole
' FILED ANO RECORDED ~
ST. LUCIE CDUNTY. ~'LA.:
- R~~OE)~`J~~ED
! '68 AUG 26 PN ~ : 09
~
~
' ~oc~a ~ oiYRas
CIERK CIRCUIT COURT
I FURTHER CERTIFY ihat I will aomply wNh all other nquirernenri of a Ipal roside~t of thls Sta».
I FURTHER CERTIFY that I have no intention to retum to my former domic~le, and 1 intend to remain in FORT
PIHtCE, SAlNT WCIE COUNTY, FLORIDA, perma~ntly. , -
..tiltlt~:ii~.,;.
. ~ ` ~ ~ ame) Gladya Bedso le
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$onor~+t~~ind wbsuibed before me tfiis dsy of . 19.1~2.
ROOER ~OITRAf "
~ ~ Notary PuWk
gy D.C. My Commission ~xpires
_ t~• b. .oo.aNd ia drppcal..~d o~toM.~ ~ii~d ~wi1b a.~k cira~t cowt, .na dup~. wi11~ T.oc As....ora
„ ~173 8fi1 -
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