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_ Declaration of DomiCile and Citi%ens~.if
TO THE STATE AND COUNTY 'fAX ASSESSOR. B j~r. 7 414
St. Lucie COUNTY. FLORIDA:' ST. LUCIE CrllNiY, FLA.
This is my declaration of Domicile and Citizel18hip in the State of FlOrida that I am filing this da)' in
accordance. and in conformity with Chapter 222. Section 222.17, Florida Statutes.
I was formerly a legal resident oL__,l!<:lE~r~_!-o_Y!!l__ ---------------- -- --- -- , -
( Ci ty)
and I resided at__
10 Elizabeth Street
; ',a ry la rd.
.-~.-- - .---+. ...---.--...
(st&u)
. However, I have changed my domicile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since
4
day of
_________n________Al)t'il_____,__________, 19_______;lJand I reside at_410__ G_eci-,:q"__12)'Cl.C~_
(Street and Number)
Fort Pierce St. Lucie
-------- ...--- -----.---- ._._-----------~-------_. -.---.------------.- ----- -, -----.-_. ------- ----- ..------- - ----..--
(City )
and this statement is to be taken as my declaration of citizenship, actual
the State of Florida.
County, Florida,
legal residence and domicile in
(Insert here any pertinent fac~, luch as lIale of property or buaineu, or relinquishment of employment at
fenner domicile, removal of family to new domicile, purchase of home, etc,)
~
Lou
Entering Kath~ ~xxtK ~eal
in' lstSrade
O~)'7(J~.J
.,.=. .. "-
-..--....-..
FILEOANO-R OROED
IN __._EOOK
19GI APR -5 nf" 10: 39
r\ C G L i\ P () liRA S, CLr~,:\
ST.lUCIE COUNTY. FLO~ILjA y:J
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_, /: " I
... :.) L.
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.-~/~::~-~>..',:_:\\:,:-,' .
, I
I FURTHER CERTIFY that I will register at my 10<'.81 address when the registration books reopen,
and comply with aU other requirements of a legal resident of this State,
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain
Fort Pierce St. Lucie
\n..___ _______________________n_____..__________...._.._Uh -..- -_____, ____..____n _u __h______.... _______ ___ __ _ ___n.._ ___ __ _ _ __ n Cou n ty. li"lorida,
(City )
~IL~------':!C--:-~m--n.---------------
(Name)
permanently.
Kenneth Seal
(Addl"'!lI)
Swum. to and subscribed Defore me thi8_n.2m__,_day cf
__ . pri 1 ----------___, A, D. HL.nl.
, ~. Roger Poitras, Clerk of cttcui t cC"'~ rt
... " I
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~"'--'~MU._~_; ~fJ~,j, (!. ' \';;;~..:"..
/ . '~. / r '...,...,," .. - .
(To be executed m dllpllca~ aDd ori,maI filed with Clerk C'.reuit Court, &Del ~~lifI;; ,ri~'~' Anenor)
"""II"'\~
Ro_ 8G"~Jy c",.. Plut CIty. Fla.
_. ... _ ......_.. (~tol i '.. {., "i .
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