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Declaration ot Domicile and Citizens~ip s
TO THE STATE AND COUNTY TAX ASSESSOR. 192`?'49
Sl. LUCIE COUNTY, FIORIDA: ~
This is my declaration of Oomicile and Citize~ship in the State of Florida that I am filing this day in accordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of Fairfaa _ Va. _
(City) (State)
6013 Pocal Drive
and 1 resided at However I have changed my domiCile
(Street and Numbe~)
to and am and have been a bona fide resident of the State of Florida since _ $th______ day of
__Apr.fl 19Z4 , and I reside at 418 NOZ'th 6th street
(Street and Number)
FORT PIERCE, SAINT LUCIf COUNTY, F~ORIDA
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 pertinent 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.)
Entering Joe Richard in the lst grade
fILEO AND RECORDED
$T. LUCIE COUNTY. FLA.
rnRf? ~'~~Rt~~~I)
192`749
; 'TO APR 29 P!~ !2 : y _
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! ri ~•OITR:.S
~ CLEr~K CIRCUIT COURT~
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1 FURTHER CERTIFY that I wi{I comply with all other requirements of a legal resident of this State.
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I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~ ~ _ : ~ ~ /u=~z~~-P 4
~ . . - UG~-,, ~
~ • ~ . . - :
~ _ ' _ : (Name
~ ~ Diane Rose ~ ~rs •Joe J.
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~ ' Swotri~to.and subscribed before me this 28th ~y of April ~ ~q 70, #
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ROGER POITRAS
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~ CLERK CIRCUIT COURT Notary Public t
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~ By D.C. My Commission expires ;
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_ (To bs executed in dupliute and original ~iled with Clerk Grcuit Court, and dupliwt~ with Tax Ass~s~or.) ~
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_ No. 13 a~~~~ 1?rl~L.~ ~