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Declorotion of Domicii~
TO THE STA1~E AND COUNTY TA% Au3SF.SSOIt,
St . Lucie COUNTY, FLORIDA ; '
Thia is my declaration of Domicile and Citizenship in
r
accordance, and in conformity with Chapter 222, Section
I was formerly a legal resident of-_____Boston! _ 3w~t
{
I:itt~ ea Pc~1 nt-•
- - -- =
and i resiaea a~ _ " " _
(3trest and Number)
t~ and am and have been a bona ftde resident of the Sta
- ----- - "February- ------------- -----~ 19_F~_:, and I reside at .
Fort Pie ce - $~
--------------------------- - -
(City)
and this statement is to be taken as my declaration of c
the State of Florida:
(Insert here any pertinent facts. such u sale of~ yropert7
former domicile. removal of family to new domicile. prim
Applying for homeste^d
~,
~~ ~~/~
~`6i _/au ~..
;~;c;~-~ ppITRQ~
S~• tUCI~ COUNir f
~ ~ITP'T.'2-d~U ~!~ATiFV that f will YHfYiRter at mV
and comply with all other requirements of a legal resider
I FURTHER CERTIFY that I have no intention to
Fort P_ierc_e
(Cih)
permanently.
Sworn to and subscribed before me this---__ 24-.day of
J' nua ry __-- ---____-, A. D. 19.61.-.
Roger Poitr~s, Clerk f C~.~
-- -
x~~~~ ~~'
ems -- -~y=- --- -----~"------ -
(To be Executed in duplicate and oriRit-al tiled with C1
~~.~w-•,~: Huooiv ~'0 4'i.~~t t'it~. FIB.