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Declaration ot Domicile ~nd Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. tUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship ~n the State of Florida that I am filing this day in accordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes. ~
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I was formerly a legal resident of _____~~x~~?~88senville___ _ New York _ ~
(Ciy) (State)
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2278 Balmer Road
ancl I resided at -__--_T-- However I have changed my domitile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since __I~IOY@m~t 1 ' day of
, 19~~_, and I reside at 419 NO. 10th Street ~
~ (Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence a~d domicile in the State of Horida. ;
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new damicile, purchase of -home,- etc.)
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Entering child in public school
O
DE
Robert Bruce Steele p,Np o~NTY, FLA- ;
F11r C1E C~ Q~cEcD
~ SS. t~-V~,~RC! !F
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~I(~~p AND RECORDED , ~
Sfit l-UCI€ COUNTY. FLA. 6g ~ '
R::GQ~r VER!Fl~Q p. p1SR ~URS
1858~1 N.o~- ~`a~~`Z ~
F RK
'69 NOV 19 AM 10: 47 ~r+
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i f,~~~~ i-AlTR~S
~ CLERK etRCUI~ COURT
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~ I FURTHER CE~TIFY that 1 will comply with all other requirements of a legal resident of this State. ;
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j I FURTHER CERTIFY that I have no intention to return to my former domic.ile, and I intend to remain in FORT
a ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. • ~
/ o~v~~. 3
~ (Name) Jeasie Towler ~
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9 S
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~ (Address) ~
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~ 18 November 69
~ '~Sworn'to and subscribed before me this day of , 19 .
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~ 1tQGElt Pq(T~A~ ~
~ ~ <XERK CtRCNIT~ COU Notary Public
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~ By D.C. My Commission expires
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~ (To b~ ~x~cuhd in dupliut~ and originsl ~i1ed witl~ Clerk iAd ~U licats with Tax Asststor.)
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~ BOOK 10~ PA~.;E 424 ' B
~ r1o. 13
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