HomeMy WebLinkAbout0684 Deciaration of ~on~icile and Citlzenship
TO THE STATE AND COUNTY TAX ASSESSOR. loV~J~
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Sl. lUC1E COUNTY, FLORIDA: ~
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in aocordance a~d
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was forme~ly a legal resideM of _ SSra DQBh _ GCpiQ11
(Ciy) (Stab) ;
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and I resided at 19 Edgelawn CitC le _ ~Wever I have changed my domicjle
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since ~-__17tb day of ;
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N ovember ~ 19 69, and I reside at 201? GolfiFievr Court
(Street and Number)
PORT PIERCE, SAINT LUCIE COUNTY, FLORiDA
and fhis statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, remova) of family to new domicile, purchase of home, etc.)
Bstabiishing residence and entering children in school
Fi~EO AND RECOR ~LA.
. ST. ~U~Of2D ~ERTF?ED
lssa92
'69 NOV 24 AM 10: y0
~-O~TRaS
CLERK CIRCUIT COURT~
j 1 FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
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1 FURTHER CERTIFY that 1 have no intention to return to my former domiCile, and I intend to remain in FORT
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~ PIERCE, SAINT LUCIE CQUNTY, FLORIDA, permanently.
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f:' Q (~L.~ ~~cni
f ~ _ ~ ~ ~ . • ~ (Name) Mrs.
: ~ " - . ~ Marie C, Martin ( Jackson )
- - ' v ` _ (Address)
-.~E~;••
" f~''°•v' ` ~ ~ 24th November 69 ~
'-'SWorn to and subscribed before me this day of , ~q .
ROGER POITRAS
; LERK CIRCUIT COURT Notary Public
gy G"~'~~ O.C. My Commissio~ expires
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~ (To bs executed in duplicate and original filed with Ge~c Grcuif Courf~ snd dupliuts with Tax Ass~ssor.) ~
aooK 18 ~
~ ~ ,3 1 ~~~,-684
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