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~o~i 16 faCE218 t;T. hUC1E CC~~~!~!lA.Declaration of Domicile and Citizenship TO THE STATE AND COUNTY TAX ASSESSOR, St. -Lucie COUNTY, flORIDA: Thia ia my decI....tion of Oomidle ~ Cltlzen.nip In 'he St... of FIoricM IMt I -'" filing thla ct.y In KCOrd'I1C8, .nd in conformity with ctYpter 222. Sedion 222.17, Fb.cM St.tutes. I w.a forrnerly . lev-I resklent oL____"'!'-t_Prun-'- ___________._ ------ - -, - ___M1sao.ur1..-------- tcJty) lStete) ~ ;nd I rMided .L l09_.Kor.t.h..)Ia~il) ___ ______________________. However, I M.,. dMnged my domicil. C3INet ... ...,....,) to.nd .m .nd M.,. been . bone fide r..ldent of the St... of florlde aince___~9:th- _________________ct.y of ____,_July_ __,____ _____.__,___" 19 _iU..nd I reald. .t ___-5022-Ragi.na-.llrl.xe~----------- -- < . CIIrMt ..... NuftlbIw) ...; ___ _ _l'.or1i_.-PierC._________________________, _____-Z1o.r1d.a---------- --------- County, florid.. tcJty) .nd this statemen~ is to be taken .a my ded.retion of c1t~ip, .au.1 l-vel residence .nd domicile in the St.te of florid.. . (1__ .... ..., pertIMnt fadl, euch . .... of "....ny 01 ---. 01 I" qJIIM.lf of -llpIoi..... tom. ....... ....-I .. '*-Iv .. _ ....... purcM. fill a-. etcJ ERTERIIG on CHILD IN PUBLIC SCHOOL' BAKRI! SUE :.~:.:.;'''f ......\120 ..~.. ~~,,"',~ "0:):' ......~ D.. ., ') .' ~I ~ 1,tj.' ,-' ........ "" ~.. 7'?'.a;....... ......;,. ..... "~';':-" ;O.-'~!: .-. _... ... .....'~-:~ ;:'.",:'" L':' .. ... ':. ':l"";' -". ~ l-: ::t.... :" . ~:.: : (/) ::: :v.:~:-.., "-- .'i~ E :: ,~~ .~,. I> .. ~ :'" : \. fI,... 't..'" -h",!t ......"-.. i \ "? eo... ...;:.. ~'...... ~.: i'" '" \". O........:......~,." i.1' . ~ ~ ,.\.1 ~. '.",~.. <'J. 10') -.....,.:. .~_.::- ~~~~..M~~~;t~ ' - .-..---..-...;:-", ....~. .. 91336 F1~~~ A~HECO~OEO lN~BOOK '96! AUG 15 AM \0: 36 RuG[1\ POi,l1:,$, Clr~K ST.lUCIE COUNTY, fLOkl~ S I RJRTHER CERTIFY th.t I will Ngister .. my IcaI .ckhu when the reglstr.tIon boob NOpef'l. end comply with ell other requirements of . .... ~ of this St...,' I FUlTHER CElTIfY that I hew no Intention to retum to my former domicile, 5nd llntend to remain In______ _ ___ ________,._ .______1B1i-.l.1.RC__------- - - . 101ft . . ~:,..-::~. " -. " .;-:?'e,U "...t'" :'" ;'_....~....~ .....;,....... ,.4.. ',-..;:'" '.,. ~ 01 ,. "'. . \ -'.~ 2 c:,,;. ~ ...... '.;' .." ", -" .. .~)'..1..: ." .;.~.J>/~:'-t'li-: 'r~,2' : - "':':." " ~;..: 4, : .,. II ..., }J-"- : ::......:, 't .'; ..,... . , :,l. "'. ,.---...).'i;!j.J)~/\.:". .~ (' ..... _.. ._v :'f.- ''W .: '...... & ~"~. ..... L" SoMlm'~~T.. ~ me"'- .. 15.-.----- dey of ___A....~-------------------r 19..Jou.-_~ , '#1-. ,,",,.' l!~-I- ___~___:. "'fl""'\\;': _ _~_____..-..._____ _______________________________________ By ~__~~ D~ . ... .. ...... ... 1 ~,. -'- ... ........ .. ... ...... a-It ~ .... ....... .... .. a-t _______.s.L-..LwI1a.------------ County, Florida, ci~aA'a-.dl'--_u H O. Oftl\nr.ll 5022 aep"a BriT. -..,CJrt-pt~1la------------- NclrIary Publk ~ ~,~ --------------------------- {'o _~ ~.. PT. ....... .i~~:';~:~~~~~~~;.~=jl~:.--.~-"~-~~~,. ~'.~ -'~---:l~:-7.cv.--"7,-y----n..': ,------- - , -