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Decloro~ion o~-~l~o~~n~c~i e--and Citizenship
TO THE STATE AND COUNTY TAB ASSESSOR.
sr Lvczs - oovrrrY, rZO$mA:
This i. my declaration of Dooiidk and Cltise~~hip in the state of Florida that I am llline this day in
accordance, and in conformity with Chapter 222, Section 222.17. Florida Statutes.
Huntington -
I was laemerly a 188a1 resident ot_,_I+4]S~~ TA?.alb u._ __,______-~, __.H,.Z..---____ __.~_~
(py) (Stag)
and I resided at_--------~~~-_.~~~_1'-~_------ --------------------------• However, I have chaa~ed my domkile
(Str«t asd Namb~s) ~~~'
to and am and have been a bona Sde rerident of the ~tattl u! ~ori~ sinrre_____-_-- --------------.-- -_-----------day of
Nooember _~_. 19 b0 , and I reside_ at__l~_ Ql~-a B~-9~i,-'-Port st.Luaie
--- (str~sc aaa tvumo.ri
lit . Piero a 3t . I.uoi a -___-county, F1orTda,
cas,~ .
and this statement is to be taken as my decLrsticn of citiseaship, actual legal residence and domidle in
the State of Florida. -
tor~r ~ ~ toto a ~domieii~. v~ore~w at.~i~e~~~~t ad ~Dloym~at at
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F~~En ~~ ";~ (? ECOl~ ~0
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I FURTHER CERT'~FY that I will register at my local address when the reslstraidon books rsopea,
and comply with sA other requirements of a k2si reslden~ o~ this 8tsts.
I FT7R'1~RR CSRTTFY that I bave no intention to return to m,Ir to~rmer domicile, and I intend to remain
~ Tt Pieroe - -_-~, Bt.I.noie _County, Fioeida,
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