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~Iaration of Dom.cil. and Citizenship
i,. iI.
lfOJX
15 PACE 236
TO THE STATE AND COUNTY TAX ASSESSOR,
q. LUCIE CDUNTT. rLA.
'~..-...- ...
St.I-'lcie
COUNTY. RORIDA:
This I. my declaration of OomicU. and Citizenship in the Stot. of Florida that I am filing this day in accordance,
.nd in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of
, LouiSV111JL, _ __._, _, ,__..
toty)
Kent.ucJc J '
(St...)
and I resided at,
2621
'. .. However. I have changed my domicile
Grinstead
~ -- - - - - - -- -. -
CSIr-' MCI NuMber)
Dr.
to .nd am .nd hove been a bona fide resident of the St.t. of Florid. since
,,~th
. .day of
July .
...
, . 19 _ .61. and I reside .t , 1116 ,$0. ,OC_e.anDt1 v.e
lSIrM' eM Number)
Ft..Pierce
_... P' ..U --, --- _ -- St.Lucie.
, . County, Florida.
(City)
and thi. statement is to be taken a. my declaration of citizenship. actual legal residence and domicile in the St.te
of Florida.
(1-, .... any pert\nenI fedl, euch .. ..Ie of ptopHty Of ~ Of "'~d of ............nt .. fotmet domicile,
-...-., of fllftlfy to _ domicile. ~ of home. .ec.)
Entering Bruce Lynn Aycock in 2nd grade
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FILED 9692~
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I RJRTHER CERTIFY that I will register at my local addr... when the registration boob reopen, and comply with
all other nqul,..."..,,, of a I~I resident of this St.te.
I RJRTHER CERTIFY that I have no Intention to retum to my former domicil., and I Intend to remain in______
________~~_._~~~r~_<<t____________________h.. ..
--- .________ __~!i_._~_~~!t______._ County, Florida,
co,t
perrNnently.
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Sworn ,.' ,,~..,..... '1 ", ) 31st July 61
,~~ ~~ ~.IhI'_ _ _______ cloy of ~--------~-- _________, 19______
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...,' " J..... ~,~ ,'''~.-. . Jan ~~~co-
~.: --~-::. V-.......7, ,.' ~~ ~... ------------- D.C. My Commiasion expires ------ _ -W!.--~_____
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