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ST, LUCIE COUNTY, FLA. -
Declorotion of Domicile and Citizenship
TO THE STATE AND COUNTY TAX A3S~BSSOA.
ss. Lis - - oovl~rY. FLOI~e:
This is my declaration of Doanicile and Citlzanship is the Sbte of Florida that I am Aling this day in
accordance, and in conformity with Chapter 22Z, Section 222.17, Florida Statntea.
I was formerly a legal, resident oi_--~El- Z~BIC--L~I~Z~---------_____, _]~l~-Z~__.-------__
(~) (8tata)
and I resided at_~~60-----~- ~F-~~--~~--~tQ~-~'&-------------------'--• However, I have chanted my domicile
(etr..t sad N,~) --- s1~~.---- ----------fir ai
to and am and have been a bona tide resident of the State of r'lorida since-____.__- __- --
January - _ 18 61 ~ and I reside at--'LQ~_-E~._~~4~_~i•T!~_-------------------------
----------____~______-,_____-- _--___-. (8tsest and Nnmbar)
Fort pima St ~ Lnaia _ -- __County, Florida,
(Clb)
and this statement is to be taken as-my declaration of citizenship, actual legal residence and domicile in
the State of Florida.
(InNrt bus ao7 vortin~at facts. web as sab a~ D~ or bvdaow. or ralingniahmont a~ rmPloymoat at
torwr domteiN. rrrmoral a~ lamib to saw domes. a~ bow. ate.)
Ent aria; oaa ohild in pnblio sahool~ Barbara Jana Zs'ati
~•~ te'''e:.: ~ 1=
_ 'i~~~.
;s~...
92110
FIL'EO ANO RECORDED
~- ~O~JK
IF!
1961 ~E8 -6 A?~ 9:59
RocER P~~rR~-s. Ct~K
St LLICCiE CalM7. I'~sA ~?~
I FUBTHEA CERTIFY that I will register at m7 bcal address when the registration books reopen.
and comply with all other requirements ai a legal resident of this elate.
i~f~i uwua :.:,r ..........•
I FU$THi~x li1lin11Fi Tjlal: i save m inteaiiaa W rerun iqu '----'"-'j'ca±o, , T t..~~..a +~ «.,n~in
~ ?ort Piaroa ~ at. Luoi•
_Connty, F'Iorida,
tGb)
(N~w)
1liiliu Yraat
_ ~ (ate...)
Swa:a to sad - ~tMrs pr *~;• t~>r a.~ at -
-• -.
~.
J.
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ep...o..a sue., rem ~ ~.._'