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PACE
Declaration of ~~Citiz.nahip
TO TH~ ~TATE AND l'OUNTY TAX A$SESSOI,
St. Lucie
COUNTY, R.ORIDA:
This it my decleretion of Domicile end Cltianlhip In the St... of Florida thet I .m filing this d.y in eccordance,
.nd In conformity with C'Mpter 222, SectIon 222,17, Florida St.tu....
I w.s formerly a I~I r..!dent of . -,. ,. Arc adia." -. _.
_ ... _, _ .ohio, .,.. __ _ _
CSIete)
(CIty)
And I reslded.t. . Rural Rt.e,ll_l...._ __u.L,_
CSIrwt .... ....,)
., Howe.,." I hev. changed my domicile
to and em end have been . bone fide resident of the State of Florida slnce_ ,. 10th '
..d.y of
___. . __ .,"., .Augus.t.. .. __ _,,19 61-,.nd I rellde .t -
,4,005. __Greenwood DriV.8_____
cser- ..... Number)
___ Fort..P1er.c.e
St. Lucie
- - - - - - - - - -- - - - ~ - - - - -.
County. Florida.
(City)
and this statoment is to be t.ken as my declaration of citizenship, actual legal residence and domicile in the St.te
of Florida,
(I~ het. ., pettlMnt '.eta. MKh .. .... of ptOPerty cw butIneu, cw rellnquia.....nt of ......~ et *- datlNdle,
~.!;, ,emit., to _ domldIe. ~ 01 ~. etc.)
Ent,ering children in Public S mool:
James
Merlin/Dawson in 9th Grade
Calvin Warren Dawson in 9th Grade
Darlene Kay Dawson in 5th Grade
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J ~ 4.24
FILED AND R.ECOROEO
IN~~OJK
19E. AUG 17 r:' 3: SI
r.o. __ :...~~ ~Io:~r~.,~~. ~_r-"
Sf. LUCIE COUNTY, Fl~I~
I FURTHER CERTIFY th.", ~ w;:: register at my local address when the registr.tion books reopen, and comply with
.11 other requirements of a legal resident of this State.
I FURTHER CERTIFY th.t I have no intention to return to my former domicile, and I intend to remain in - - - ~ -
__""''',':;~~ ..Pi..eree-- '
, .,', \ L ; ,(City)
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Sworn' to and subscribed l>>fore me this,
S_t .L.\l9l e ,
County, Florid.,
~
v1:~tf:~
4005 Greenwood Drive, Ft.Pierce
~)
17tb_ _ _ _ day of ___~!l~st
61
., 19
By u~~~_C:.T D.C
Notary Public
My Commission expires -
(Ye ... ..ecwtM .. ...... ... ......... fiJH wIIIo a..t. arc.. c-t, ... ~ wi;lo 'ex ~)
...ao. ". ..,II:_ell: