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Declaration.' ~ Domicile and Citizenship, ... ~ C)(l~
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TO THf STATE AND COUNtY TAX A$5EsSoI, . '''c E COUMTl, fl~.
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St. Lucie COUNTY, flORIDA: ~ - ,............~--
'Thi. I. my declaration of DomIcile Met Otizenlhip In the State of FIorieN that I, am filing thl. c:Ny In eccordMce, .
and in cOiifonnIty with Ch.pter 222, Section 222,17. FIorieN St.Mea,
I wa. formerly a legal resident of ____nhfa'"'_ ____ .____________________. ..__IIa..achuaet.tiir
(CIty) ....)
and I-r~ af- ." _.~~~_~mM.Jl.o,.~________________________. However, I have cNnged my domicile
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to and am and have been a bona fieN resident of the Sta" of Florida .i~____._~_________________."__day of
July 61)<Xl ~. )3rcl St..eet
___. _ _."._, _____ ..__ .__ ._____________. 19_____. and I reaide at ----------..--- ------------------------- -
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__!~~._~~~-c-~--..--.------~---- ..____.._____, _'j;_L~~_~________n_'____n____ County, Florida,
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and thi. .tatement il to be taken .. my declaration of d~p, actual .1 reaidenc:e and domicile In the Stat.
of Florida,-
(I.... .... .., ,..,.... ..... IUCh .. .. 01 property . ..... . ,"~I"~.A>l1I 01 .........-.. .. -- .......
,_ --' 01 femlly 10 _ ...... purcN. 01 ..... eM.)
Entering Harold Dean Sayage in 7th Grade
· Marjorie O'lell Savage in 12th Grade
97383
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~F1l1~ ANa RECOR 0 l~~,.~'';/,~ ", ..l~"".""
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ST.lUCIE CDU~~r.A:! CLfr.x '~";;.;j~":" "",..
, FLDRIDA cJ)' ~""'.;:",1 ".;~".,.
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I FURTHER CERTIfY thIt I wlSl ,..... at my IoceI eddnM when the reglstretlon boob NQpen, end comply with
... other .-.quit.........of 0 .... ......... of this $tate. ,- '
I FURTHER CEITIfY thIt I ..". no Inlilntlon to return to my former dornidle, __ I Intend to remeIn m______
'011; Pieroe St. Lucie
____________________________________________ . ________________________________ ~,FkMide,
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Sworn to end sUbecribed.... me this. .16 -7~--- dIy of _____________..~t___-----__. 1,9-61.--
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My Convnilaion exp&tM '________________________ -,
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