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Declaration of Domicile and
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TO THE S!-ATE AND COUNTY TAX ASS~SSOR,
St.Luet.
COUNTY, FLORIDA:
Thi; is my d~lar.tion of Domicile and Citizenship in the State of Florida that I am filing this day in accordance,
and in conformity with Ch.pter .222, Section 222.17, Florida Statutes.
I was formerly a legal resident of
Kohala
Hawaii
(City)
($t.te)
and I resided at
BOJC 158 -
~ and Number)
However, I have changed my domicile
to and am and have been a bona fide resident of the State of Florida since
12th
day of
AUgust
, 19 61 ,and I reside at
201 Beach Ave~Rjver Par~_
($,...1 and Number)
St.Lucie
County, Florida,
Fort Pierce
(City)
and this statement is to be taken as my decla.ation of citizenship, adual legal residena~ and domicile in the State
of Florida,
(1_ ..... atr'f pertineftr f-. auch .. .... of property or ~. or t.llnquW-r of emplotfMll .1 tom- domkl",
remcv.1 of ,.....Iy 10 new domicile, pur~ of home, etc.)
Entering Carol Lee Boyson in the 6th grade
97559
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I FURTHER CERTIFY th.t I will register .t my loal address when the registration books reopen, and comply with
.11 other requirements of . I~I resident of this State.
I FURTHER CERTIFY tNlt I have no intention to return to my former domicile, .nd I intend to remain in_ -- ---
_____F-er.t._.Pier.c.e ______________________ u
(Qyt
_u__u~_t!~1.~~~_E!___ _____ _ ._ County, Florida,
permanently.
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(Addre.)
19___
61
By
D,C.
Not.ry Public
NoWY PubIk:. Steta of ~ at larp
My Commission ElIptfe$ Jen. 15, 1964
My Commission expires _~~~...nSilOltt~.:.~-~' Y.
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