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Declaration of DMsicile and t;ih~>~"'.'h '
TO THE STATE AND COUNTY TAX A..Q1.l~B,
St. Lucie _COUNTY. FLOllIDA:
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nu. ia my declaration of DomJeUe &ad ~lp in the State ., Jbfda that 1 &Ill ftHDc i:hIa da1 ill
aceorGance, and in conformity with Chapter 222, Seetlon 211.17. I'Ioridll Statu_.
I was formerly a lepl realdont \)f____9~~_~ Ch!:~:sti:.~ _. ____ T~8 ____
, 1034 Shepherd' ((JQ') .t.....)
and I re~Slded at.....'m ..'.. ,.."....--..-------,---------,--- However t have cbaDaed ID1 demlcUe
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to and am and have been a oona Me reeident of the State of Florida lince..__,_,.._,1.~"___,___,___.._______day of
March 61 314 N. 17th Stl"Sut -
"..______,,__,..__.._____..,..,..,_,_,__..___,___', 19______. and I reside at.___________ _._.__________
Fort Pierce St. J,u6ftr" ad 1f1llUer)
~__________________________.________________ ____, _______ ...:--____ __eo,UJ1Q'. F'J.orida,
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and thia statement is to be taken aa my declaration of cltiz<<lehip, actual- leaal residence and domiclle in
the State of F1orida.
(lnMrt here any pertinent facta',luch .. aale of _pI'Opert.J or ~"-. or nlIDqviabJDnt 04 emplo7JDGi at
former domldle, remoTal of famil7 to nrw domldle, parehue of 1aoIIie, Me)
Entering James Michael Shavor in 7th Grade
" Patricia Ann Shavor in 2nd Grad'
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I FURTHER CERTII'-'Y that I will regi!lter at my locr.l addreu when the re,istration books reopen,
and comply with all other requirements of a legal reeident of thi8 State,
I FURTHER CERTIFY that I have no intention to return to my fonner domicile, and I intend to remain
, Fort Pierce St .Lucie Co t F10rida
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JameS-Barne;~avor
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(T<I be uKUted in duplleate and oricina1 filed with C\.n G:ircuit CovJt, ad chI.,,&atf ,~\ Tu. Aueuer)
Sworn to a!'ld subscribed before me thi2L~~--_- .day of
Rn_n BuDDI)' Co.. P"lIt Cil'. FIa,