HomeMy WebLinkAbout0261 . ~
D~ciarati~n og Dorv~icite an~i Ci~izenship ;
t.~~~~~35
TU THE STATE ANb COUNTY TAX ASSESSOR,
Sl. LUCIE COUN7Y, FLORiDA:
Tf~is is rny declaration of Domicile and Citizenship in the State of Florida ihat f am filing this day in accordance and
in conformity ~vith Chapter 222, Section 222.17, Florida Statutes.
I was formerly a iegal resident of __~T~_'~+ARTH ` 'I`EX~
~Lf~~/~ tJi~iG -
~
3913 London Lane Nowever I have changed my domi4ile ~
and I resided at - - - - - - .
(Straet and Number)
to and am and have been a bona fide resident of th~ State of Florida since lII~
- - day of
----1?~~~ub~Y` _ 19~?~_ and ! rssids ar _ 1608 Boston Avnl._
(,Street and Numbe~)
FORT PIERC~, SAIt~IT LUCIE COUNTY, FLORIDA
and this statement is tn be taken as my declaration of citizenship, actual legal residence and domicile in the State of Flo~ida. ~
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment ~
at former domicile, remova) of family to new domicile, purchase of home, etc.) ~
E.NTERING 2`~Q (2) Q~iILDREN IN PUSLIC S(HOOL
WENDELL RAY THOMAS (8 yrg) FI~'tTTiie~c p tt~C~iIIR~00K
DutI3-i~ ISA~ fix~AS (7 y~~) ..r.-~
'66 JAN 3 Af~t 9: 4 7
- ~.~1~~35
rt: , ROG~ii ~ i)il ~i:.S CI.ERK ~
•"%•,,i:i-. •ST. LUCIE COU?2TY,
~:~',r '~r,,~ t=LORIDA
- ~ . ~t 'J9'J-:.,: ~
. r;',> ~
,
. , 4 r
'
' ,t~
- 1. • ti t'`').• \
'~~~f. I ~ ~ .i\~~`.
. :~'~ii1'.1'
! FURTHER CER7lFY that 1 wil) comply with all other requirements of a legal resident of this State. ~
. ,
. i
I FURTHER CERTIFY that I have nq intention to retum to my former domi~ite, and ( intend to remain in FORT ;
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
. n ~
, , ~ • ; ~ t : . . , _ /[~ii / ! ? /In.
T
4 (Name)
: .~v •.i~a 4~ .
.•1 •a. "
~
J i
' \ •r~~ ~ ~ •C~ " IRIS A. TH~"~AS
- . : i i~ . , :
: ~L = w 3u y' ~ _ ; ~ ~
: _ ~ _ (Address)
,
~ ; J', , :
' : , ? ' j :
. • , v ~
~-~f %,~••.,,,,~,,.~ivo~~~o and subscribed before me this ~rd day of _~L8II1tST~ , ~Q 66
" . ` i ~ (1 .
•.,f~ • + ~ C,
•
ROGER POITR/~S
CLERK UIT COURT Notary Qublic
BY ` D.C. My Commission expires
(To be executed in duplicate and origina! filed with Clerk Circuit Court, and dupliute wit~ Tax Assessor.)
$oo~ 135 261 ~