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1`75'~"90
Oeclaration ot Oomtcii• and C~ttsenshlp
TO THE STATE AN~ COUNTY TAX ASSESSOR,
Si. lUC1E COUNTY, FIORIDA: .
Thi: i: my declarotio~ of Domicile ~nd Gti~snthip in tM St~t~ of Florida th~t 1 am Nll~q th3~ day in aooordano~ ~nd ;
in conformity with Chapter 222, Section 222.i7, Florida Statuta. :
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I wa: formsriy ~ Ipal ~id~nt of Pnrt pi.,~w Florid~
taH) (Stat~) ~
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and i rasided at 30S N~rth 2t ~ C~r,.e; How~ 1 haw d~anp~d my domidlt
(5tnet a~d ~Number)
ro~nd am and have been a bo~a fide reside~t of th~ Stats of Florida s~na _ 1?Iareh 19th
1?larch 1946 ~ 3Q5 t~1~ ~t ~ t~
(5tnst a~d Numb~r? :
FORT PIERCE, SAINT LUCIE COUNTY, RpR1pA
and tf~is statement i: ro be take~ as my daclaration of citize~uhip, ac?ual le~al ~idenos a+naS domial~ in tht Stat~ of Florkla.
(Insat here any pertinsnt faets, such as sale of property or busineu, or nlinqui~m~nt of ~ny~loym~nt
~t forme~ domidl~, nmoval of family to r~ew domkile, purchast of home, ~
Bstablisb Resideacy for hoAestead
• RIlEO AND RECORDEO~ ~
ST, LUCIE COUNTY. FL'Ir;
RE~:'0~?0 VERtFlEO
:I~aS I ~1Q
'69 MAR I 9 AN I I: I Z ~
~zo~~R r'OITRAS .
CLERK CIRCUIT COURT'
i FURTHER CHtTIFY that 1 will comply with. ~II oti~ nquinrrMnts of a IeDai ~uidsnt of this Sta».
1 FURTNER CERTIFY that i have no intent~on to retum to my former domic~le, and 1 intend to rema;n i~ FORT
P(ERCE, SAINT LUCIE COUN7Y, FLORIDA, parman~nNy.
~ . - ~roraea Jean Ma~?eli
~ _ ( Mra . Tho~as w. )
44ddr~ss)
Swan~~ ~~ubs~?ibed b~for~ m~ this 14th ~y ~ 1~a=~b , 19 69
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