HomeMy WebLinkAbout1370 ` - ~ I V1GG7rV
De~laration ot Dorttiail~ and Citlz~nship .
TO THE STATE AN~ GOUNTY TAX ASSESSOR,
ST. lUC1E COUNTY, FlOR10A:
This i: my declaration of Domicile and Citinn~ip in ths S/ate of Horida that 1 am filin~ thit day in aooordana ~d
in aonformity with Chapter ~22, S~tfio~ 2~2.17, Florida Statutes.
i wa formerly a ~.qal ros~nr of Xhesli~qg wset Virginla
(City) tSt~»)
and 1 rosided et g. D. 4 Boz 415 . F~IowavK I haw charq~d my domici~
(Stro~f and Nun+be~)
to and am and have been a bona fide roiident of ths Stste of Fbrida unce 5th _ day of
se~tember , tqst$_, and 1 roside at 612~ 8outh 4~h St~ce~t
(S1reN s~d Numbsr)
lORT N~C~, SAMlT L11C~ C011NTY, RORIDA .
and this stat~ms~t is to be taken aa my dsclaration of dtizenship, echral le~sl residenoe and domkile in fhe State of Horida.
pn~t hsre a~r pe~tinent fads, wch as ~la of property or bu:iness, or relinqui~mant of employment
at former domidle, nerrwval of family to new domicile, purchass of ha~ne, etc.)
Sntering l[arY 8tephea Ritohi~ in the 5th
G~ad• o! 9ohool.
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1 RJRTHER G~tTiFY that 1 will oompiy with aii ott~er nquirerrMnts af a le~l r~ident of thb Stat~. ,
I FURTHER CERTIFY thst I have no intention to retum to my former domidte, a~d I i~tend to romain in fORT
PIERCE, SA1NT LUCIE COUNTY, FLORIDA, permanently.
s ,
~a~~ Betty I~otl 8ltohilG
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_ - (Addross)
`~,~vlporn'io,aii~'wtucribed bsfore me th~s 6th ~ 8sptember 19 68 .
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. :n C~~ CIRCW~ ~OURT Notary Publk
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By D.C. My Commission expi~
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(T. b..o~.e~Md M d~rplic.i~..ud o~i~al til~d wi1M a~lc cire~f ca~. .nd dupiie.~. wiN~ T,oc Aw...e.a
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