HomeMy WebLinkAbout2864 o~cluatlon ot oomiail~ a~d CltisMShip 1`~'1233
TO THE STATE /W~ GOtJNTY TAX ASSESSOlt, -
Sl. WCIE COUNTY, KORIOA:
Thb is my dacla~ation of Oomicile and Giti~nship in tht Sta» of Horida that I am filirq this day in ~ooordana +~d
in aoniormiry wtth Gh~pter 22~, S~ttion 222.17, Horida Shtuf~.
~ was ~onn~ly s ip,~ r~sid«,r of Flint Yiahigan
tCity) is~~~
~ ~t 1067 l~enton Hills ~ ~
. (Str~M and Numbsr) .
ro and am a~d have besn a bona f~d~ rosident of the Sta» of Florida stno~ OOt. 12 day of
, 19 68~ a~ i~~ ~ ABC l[obile Park - 919 25th Streat
(Str~et snd Numbsr)
lO~T ~Cf, SAMlT LUCI! COtINTY, RORIDA
and this stat~nant is ro be taken as my dedaration of citiz~snship, aduai le9al ~esidenoe and domkik in ths Stat~ o~ Hortd~.
qnsert here any pe~tinent fads, such as saie of property or business, or relinquuhment of smploym~nt
at fon+n~r domicile, ~~moval of family to new domicile, purchase of home. N~c.)
Placing ohild ia public echool - Patriok
ST~ ~
C E COUN~y FLA.
fz~.i'~1~~En
'68 OCt I 4 PN ~2 : 3 ~
-
I' -
~ , ~
I R~GEt7. POITRAS
~ CLERK CIRCUIT COUF~T
~ .
I FURTHElt G~RTIFlf that i wiil comply with ~11 o~fh~r ~equtrarrwnh of a Ipal ~id~nt af thb Stat~.
1 FURTHER CHtTIFY that 1 have no intentwn to retum to my former domicple, and 1 intand to ramain in FORT
PIERCE, SAlNT UKIE COUNTY, RORIDA, permanently.
v
~ Mame) JacY 8 Branwell
~ . . ~ :
~ = -
. ~ ~ - U~dd~ss)
,
- - 14th Octobsr 68
~:SwQrr'tli~ ttid wh~crib~d b~fon n~e this diy of 19 .
~ : v~.e,~~~< •
~ ~~f
CLMK C~GIR • No~ary Publk
b~r D.C. My Gomrnasion ~xpint
R~ M~~ M r~lieM~ a~i ~i~M~l AI~ wM~ CIMk Gnrlf C~y awi ~ wii Tao~ A~~.y
- ~17~ ~ .
, Mw i9
.
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