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Declaration of Domicile and Citizenship
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TO THE STATE AND COUNTY TAX ASSESSOR.
ST. LUCIE COUNTY, FLORIDA:
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This is my declaratio!l of Domicila and Citiz.enahip in the State of Florida that I am filing this dJiY in
accordance, and in confonnity with Chapter 222. Section 222,17, Florida Statutes.
I was formerly a lepl reaide!lt of....... \'JASHllJGTON ............... ................,..... .DIJTRICT._O....'.. COLill.lBII'.
. (City) (Stat-e)
and I resided at.. ,5Z07 Sherrier.Pla,ce,,...lL.. ,vI.. , However. I have changed my domicile
(Street and Number)
to and am and have been a bona tide ruident of the State of Florida since 4 th day Qf
......._..July:...............'....hh...h...h. 19.69-. and I reside at .........102...Entrada A ve....lli v.er Park,
(Street and Nl>mber)
......EQ.:rt.....Ej..!~rg,~.h..__.._..h....h___..._......h.'. _"h'~'~'" L.u,c.i.e........,..., .............' ...... ... .. .. County, FloriJa,
(City )
and thia statement is to be taken as my declaration of citizenship. actual legal residence and domicile m
the State of Florida,
(lnaert here any pertinent facta, .uch u ...1. of property or buaineaa, or relinQl1iacment 01 employment at
former domkU., removal of family to neW- domicile, purc:ha.. of home, etc.)
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I FURTHER CERTIFY that I will register at !Oy local addreu when the reaistration books reopen,
and comply with aU othei' requirements of a legel resident of tlm State.
I FURTHER CERTIFY that ! have no intention to return to m,v former domicile. and I intend to remain
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d1'yde Arnold McFarland
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(AOdret. )
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(To be ~~ted m chq)1 '-.,:.~:'~ ft1~ wkJl a.n CImdt Court. &ad dapUeat. with Tax }~)
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