HomeMy WebLinkAbout1016 ~~~la~ation ot Dort~icite and Citizenshlp
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10 THE STA1E ANU CUUNTY IAX /1S,SE~.SOR. ~
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ih~s :s ~»y .lcclere~w~? cf Voin~cile end Citizonsh~p ~n the Ste~~ of F!or~de that I e~n I~I~ng this day in eccotdenco and
,n coi~fnrmity with Chapter Sectio~~ ??2.17, Floride Sletufes 2
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I wes famierly e le.~el ~crs~dent of Kinston North Carolina
(Cityi • (State)
.,nd 1 ~es~ded at x0ute ~ However I have ch'anQect my domicjle
(Street and Number)
and am end heve bcen + bone f~de res~dent of the Stete of flaride sincc Z6th dey of
Sentember ,r;~ t{l.iiU4 Ht 1~3ox 514 Airport Road
(Street end Number)
FORT PlERCE, SAINT lUC1E COUNTY, FIORIDA
,~nd th~s staternent is to be ~aken as my declaration uf c~tizenship, actual legal residence and domicile in the State of Florida.
(Inser~ here any pe~t~nent fads, such as sale of property or business, or ~elinquishment of emplpyment
at forme~ domicile, removal of family to new domicile, purchase of home, etcJ
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f 1~ED ANO RECORDEp" F
Enteri.n~ Berry in the lst grade ST, ~~CIE CQUNTY
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" Timothy in the 5th grade ,la S~P Ze ~~~32 ;
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" Danny in the 6 th grade ~ 21 ; ~y~ .
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RK~C RCUIT CO \l J
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1 FURTHER CERTIFY that 1 will comply with all other requirements of a legal resident of this State.
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1 FURTHER CERTIFY that I have no intention to return to my former domic,ile, and I intend to remain in FORT
FfERfE, SAINT IUCIE COUNTY, FLORIDA, permanently.
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4-g.';'-,- a"s ~t _ Ludie Gay ( BGrs Emmett ) Hill
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~ Swotn fo and suburibed before me this ____28th day of S@pteIDbeT _ , i9 70
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ROGER POITRAS -
K CIRCUIT COURT Notary Public
By L~ _~'~L _ _ D_C. My Commission expires
(To b~ ~x~cuNd in duplicate a~d ori~inal fil~d with Cl~trlc Grcuit Court, and dupliub with Tax Assessor.)
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