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Declaration ot Don~icile and Citizenship 18`i ~11
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordante and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
Nosth Baltimore Ohio
I was formeriy a iegal resident of -
~C~ty) (State)
317 i~ 8th street
and I resided at - - However I have changed my domicjle
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 23id _ day of
cember_.R , 19 69 Rt 3 Box 524 D ~
, and 1 reside at `
- ree a u
fORT PIERCE, SAINT LUCIE COUNTY, fLORIDA ~
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pe~tinent 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.) -
Bntering 3 childrea in the elementary school
~
~~~~i
lE0 AN~
Billie Rader in the 4tb grade F~ ~1.~
ST, lUC1E CO~~~~RD~p l
1'r r.~?n ,~r~~~Y ~LA:
Walter in t he 3rd grade
Jimmy in the St~ lst grade 'l0 J~4N S~ s
~ 7
~ ~~ERK^~; ~O;~F~
~ C;~?~UtT ~pV
~ RT.~
~
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1 FURTHER CHtTIFY that I will comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domiGle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~ .i_, ,~~;r,~i ~ ~~vttt ' ~ll~c"' _
~ ~ (Nam
~ - _ . iixasz~fx Darre~~ Rader
~ - . " . -
_ .f.
xi ~ ~ . : (Address)
~ . -
~ , ~ 'r' • .
~ = anuar
~ Swom to and subscribed before me this Sth day of J y , 19 70 •
~
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~ ROGER POITRAS
~ K CIRCU I COURT Notary Public
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~ By ~t~«t-' ~~~L D.C. My Commission expires
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~
~i
~ (To be axecuted in dupliute and origi nl R Isd with ~lerk Circuit Court, and duplicats with Tax Ass~s~or.)
~ BOOK 182 ~;r,E
~s ria. i 3 ' ~ - .
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