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Declaration ot Domicite and Citizenship
TO THE STATE AND ~OUNTY TAX ASSES~R,
51. IUCIE COUNTY, FLORIDA:
This is my d2claration of Domicile and Citizenship in the State of Florida that 1 am filing this day in actordance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
Houston Texas
I was formerly a legal resident of - -
(City) (State)
10226 Galvaston xd. ~
and I resided at _ However I have changed my domitile t
(Street and Number)
to and am ar~~ have bee~ a bona fide resident of the State of Florida since 1 S t day of
_ ApTil_ ~9?~ , and 1 reside at Bluefield Rd.
(Street and Number) ,
P.O. Box 368 Okee. 33472
FORT PIERCE, SAtNT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile i~ the State of Florida.
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~inseri nere any per3inerii iatis, suth a3 s~~~ 6€ pfO~ieriy ~r ~usin~ss, c3r ~~iir?yuis~?me~st c~# E~:+~3oyr8~ti ~
at former domicile, removal of family to new domicile, purchase of home, etc.)
(School Children) .
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' FILED AND RECOftBED~
; ST. LUCIE COUNTY. FLA.
~ Karen 'Nildes - 2nd Grade - Re.CORD VERt~~ED
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~ '10 APR 6 AM 3: 3 8 /A/ ,
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~ I fURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State. i
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~ I fURTHER CERTIFY that I have no intention to return to my former domiCile, and I intend to remain in FORT {
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~ P~ERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ViOlet WebsteT
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~ (Name)
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~ Sworrt to and subscribed before me this 6~h day of April ~ 19 70
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By~. - D.C. My Commission expires 's
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~ ,,~To~.~ieecplsd in duplicate sr~d originsl ~iled with Ckrk Circuit Cour~, and duplicat~ with Ta~c Assessor.)
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; BooK183 PACE256~
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