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~ Declaration o! Don~lcile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
ST. IUCIE COUNTY, flOR10A:
1883~~
This is my daclaration of ~wnicile and Citizenship in the Stais of Ftorida that i am fitin~ this dey in acoordanos and . ;
in conformiy with Chapter ~22, Section 2~2.17. Florida Statutes. ,
1 was formerly a legal ~esident of - RYc B@a Ch N. H.
_ ~ (City) ~ (Stata)
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end 1 ~esided at OCean Blvd. 21 ~„Ve~e~ ~anped my dcmic~le
; (St~eet and Number)
' ro snd am and have bee~ a bona fide ~esident of the State of Florida sinoe 12th ~y ~
Januiry , 19 70 , a~ at 511 So. Ocean Dri~e. O~'ean View Apta.
(Street and Numberj
FORt MERCE, S/UNT ~UCIE tOUNTY, RORIDA ~ ;
and thi: statement is to be taken as my deciaration of citizeRShip, actual legal rasidenoe and domicile in the Staro of Fbrlda.
(Insert here any pertinent facts, such as sale of property or business, or ~elinquishment of employment
at former domicile, nmoval of family to new domicile, purchass of home, etc.)
SHARAN RUrN HADLBY 15 yeara l$83~~
F?(.ED AND `
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GLFRK ~JRCUIT COURT ' ~ '
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! RJRTHER CFRTIFY ti~at 1 wil! oomply with ell other requirements of a leyal msident of this State.
' 1 FURTHER CERT(FY that 1 have no intention to retum to my former domiGle, and 1 intend to remai~ in fORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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- RUTH P. HADLBY
(Neme)
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.~~/V~~~ GU~ `'%i - Sll So. Ocean Dr. Ocean Yiew Apts.
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y.S~ii~o t~'a~subscribed before me this day of Jsnuary 19~Q.
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~CIitCU COURT Notary Public
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BY D.C. My Gommissio~ expires
(Te b~ ~x~cut~d ~ dupliat~ and oriqinal fil~d with Cl~rlc Gra~h Caw~, and dupliut~ with Yax A~swra
~~gqc~~~ P11CE ~e1~V
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