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PAC( 65
.......... . ...... ~
Declarati~~ T o'fUCMMtlWlltnd Citizenship
TO THE STATE AND COUNTY TAX Ar..sESSOR,
ST. LUelL_COUNTY, flORIDA:
This is my declaration of Domicile end Cit\ze;Ilhip In the ~ 9f fIorid& that I am filing this ct.y In ~nce,
and In aH-.formlty with Chapter 222, Section 222.17, f~ Statu....
ONEONTA
I was formerly a legal r"!dent of, _,'
N. Y.
lCJIyl
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and I resided et
3 Pot~e~, ~!~_~_ __, ____ ,_, __ __ __nO ,.__.. Howev~r, I have changed my domkile
tstwMt __ ...........1
to and am .nd have been a bona fide resident of the State of Florida since.... , _. ~~1i.'u_, _ __. u' ,.._da" of
JULY
, 19_~~, and I reside at "ltQ7,Jte~1l~~9__~~_L_u__ ,_____,..__
(SINet' Met ~)
FT. PIERCE _ ,. _ ,un,__
(Cltyl
___ S.T LWCl!.._ _, _, u _ ,. u,_ ,_ __ County, Florida,
and thi, ,tatement is to be taken as my declaration of citize/1$hip, actual leolal resid4tnce and domicile in the State
of Florida.
(InMrt her. MY' .-rtiNnl f-. wch .. Mle of ptop<<ty w ~ w relinql W--, of ....Iovmatlt .. tor- doMIdIe.
..-.1 of f-'lv 10 _ cIomidle, ~ of ,-, etc.)
ENTERING ONE CHILD IN PUBLIC SCHOOLS
C LAU DE R. l-rnRWIN
6 yrs
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97662
FILEO AND RECORDED
INcUt"l(tf"l Rt'?dJLBOOK
196: AUG 2'. PH 2: 49
. '_...., "'OIT"'" "lr"v C\ _ ~
sr.l'u'ciE jCOUN'I\y:HuK'lUA~'
I FURTHER CERTIfY that , will register at my Ioc:.tl address when the registration book. reopen, and comply with
all other requirements of a legal resid4tnt of this State.
I FURTHER CE~TlF,( that I have no intentiqn to return to my former domicile, and I intend to remain in_ _.' _ _ '
FT. PIERCE
. ---_. - -.- - -
(CIty1
ST. LUCIE
, ,County, Florida,
_ ,n_~)~'~
CLAUDE R. MURWIN
(Adclr->
24th
AUGUST
day of ____, _u_,.
, 19_ ~l
Notary Public
r
By
My Commluion expires _ ,,__,_____u_, "n_'
(fe ~ ..... ... ......... .... ...... .... willa a..Ir CIrcwIt Cewt, ... ....... wtIIt 'ex ~
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