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D~claratlon ot OorMicfl~ and Citis~~ship €
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TO THE STATE ANO COIyNTY TAX ASSESSOR,
51. WCIE COUNTY. F~oR~oA: ~ 1~`7348
This is my decla~ation of Domicile and Citizenship in ths Stete of Florida that 1 am filinq this day in aooord~noe a~d
~n confo~miy with Chapter 222. Section 222.17. Florida Statutes.
I was formerly a legal resident of Charleston S. C.
_ Kiy) (Stah)
and I resided at _ 632 Weet Oak FOreest Drive However I have ch~nyed my domitile ~
(St~aet and Numbe~)
ro and am and have been a bona fide resident of the State of Florida since July 5 day of
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- . 19 70 , and I reside at ~
- (Street and Number)
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.
(~nsert here any pertinent facts, such as sale of property or business, or relinquishment of employment
et former domicile, removal of family to ~ew domicile, purchase of home, etc.) _
Sntering children. in school-. ~
'.fIL'EO'AND~REC01t0~W. ,
S,T. LUCIE COUNYY. F~A~-`
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RECORD VE;19~3~~8 ~ .
Tommy, Rhonda and 3onya Skinner 'iQ ~(j~ ~a ~ 3'09
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ROGER POITRAS
CLERK CIRCUIT COURT~
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( I RJRTHER ~ERTIFY that I will aomply with all other requi~ements of a le~al resident of this State.
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~ I' FURTHER CERTIFY that I have no intention to return to my former domivle, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUN~Y, FIORIDA, permanently.
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- (Name) phyllie Skinner
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~ - (Address) .
_,:Sryol1M~o~,4nd subscribed before me this day of , 19,,C~1.
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. . .lOOER'~T~/~3 .
, ~ R fOt1RT Notary Public
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6y.' - .C. My Commiuion expires
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R:'li~'~«+rNd i~ duplseal..nd oe~nal fil~d wilb ehek pKUk cow+, .nd dupiie.~. wiM~ T.a A.....e.a
~ a~ 186 ~ i36'1 ~
No. 13 . . - - ~