HomeMy WebLinkAbout1072 Decla~ation ot Don~icile a~d Citi:~nship ~7,2~~~
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. Ll1~lE COUNTY, FIORi~A:
This is my declarotion of Oomicile and Ctizenship in the State of Florida that I am filin~ thit dsy in aooordanos end
in oonformity with Cb,apter ~22, Settion 22?.17, Fiorida Statutes.
1 was formsrly s 1e9a1 resident of Oneonta Alabama
(City) (Stah)
and 1~ided at ROUte #1 . However I have charped my domic~le
• (Street a~d Numbe~)
b and am and have been a bons fide resident of the Stste of Florida sinoe 3rd day of
November ,~9 68, and ~ reside at 2009 North 3rd Street
(Street and Numbst)
FORT NERCE, SAtNT LUCIE COUNTY, RORIOA
and this statement is to be taken as my declarotion of citizenship, actual legal residenoe and domicile in the State of Horida.
(Insert here any pertine~t facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Placing Children in School
Deborah Lynn Tadlock - 9 years
Shelly Marie Blackmon - ? years ~
FILED ANQ RECORO~Dj
ST. LUCiE COUNTY. RLA: ~
RECORD VERI~IEO
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'68 NOV I 2 AN 0: 3 2
~ M
f R ER POITRAS '
~ CLERK CIRCUIT COURTi ~
I FURTHER G~tTiFY that I wiil oomply with all other requirements of a le~el resident of this State.
I FURTHER CER7IFY that I have no intention to retum to my former domicjle, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
. ~
. - (Name) Katherine M. Blackmon
a'D09 N. 3rd St. , Ft. Pierce, Fla.
~ `y. :'v ~ G~' _ (Address)
J . G-~•
~ ~ ' ' 12 th November , ~q~$
~~Sworn ~o.'s~ subscribed before me this day of
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. - ~ U ~~~ORRAS ,
t COURT Notary Public
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By - D.C. My Commission expi~es
(Te b~ ~x~cuhd ie cN~ and ori ~al fil~d whh Cl~rlc Ciraih Couif, and wilh Tax Aaasor.) ~
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d~00~l~~~~ P~6E~~ ~
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