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du5i 10 PACEJJl;
. T, UICI[ CCUHTY. HA, Declaration of Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
_ _~&_Luc1.e____COUNTY. FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance,
and in conformity with Chapter. 222. Section 222.17. Florida Statutes.
(City)
Kent\.l!::JcY
CSt...)
I was formerly a legal resi~ent of
Plkev111e
and I resided at 204. College s.treet
($trMt ...d Number)
However, I have changed my domicile
to and am and have been a bona fide resident of the State of Florida since ' :3 rd day of
August , 19 61 ,and I reside at 209 N_o~th__~~~ Street
(Srnet ...d Number)
Fort Pierce
_ .(CIty)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
, . _.St., Lucie.
. County, Florida,
(INert .... ...y pettinem ,.... auch .. .... of property or buUMM, Of rellftqvllt_ot of empIoo,..." .t '-- d0MlclIe,
....-.1 of 'emIly to _ cIarnIcl", punJ..e of ,-, ..,
Purchasing a home
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f\LEO AN RECOROEO A-:'>::,~:~~ .:;:'
\u '. BOOK ,-/.~....,;:'{; .': ~ :,;~':',':,::::;:: ,
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'96\ AUG' 1 nn \0: ~O '., i~~ ~.~J~' ~. :;,<~~~.~ J~,
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Sl.lUtlE COUNll. fl~"'"f ~.'):~,.;.'.?,.,
I RJRTHER CERTIFY tNt I will register at my aoc.l addr.. when the regl.tr.tlon boob reopen,.nd comply with
.11 other requirements of . I~I ~lclent of thl. St.fe,
I RJRTHER CERTIFY IMt I have no Intention to return to my former domicil., w I Intend to ~In In______
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{'I,,! .u;":.:~~:'----- ___ ____________________ ___
-- -----citoGa PCXTRA5.~IT COURT
~ Yl'lJfi1.&-- - - ~____m___ DL:
ere lie ....... .. ...... .. ....... ... ... a.l o.It CeM, .. ...... ... ... .....,
__u__-8L._WC1JL_-'__________ County. FIorId4l.
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Robe~ MarrlD~tatt
209 lorth "-Oth Fort Pierce, Fla.
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~
17tJL_____ day of _AqaR.._____________________. 19_~~__
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Neary Public:
Aly ~ ~nM ___________________________
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