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Kb!l 17 PAGE256
Declaration otl.QgitMtr"M, Citizenship
TO THE STATE AND COUNTY T.~ ASSE3SOR,
St_Lu~ie
COUNTY, FlORIOA:
This Is my dldaratlon ~ Q.,mic:11e end Cltlunahlp In the Sta" of Florida thet I am filing this day In accordance,
and In conformity with Chapt<< 222, Section 222.17, flor!de $taMes.
..,. I wa, fomwtrly a legel.....ldent of. .___ ____ ,____~o~~~~__________________., -,-' .----.----.---.--.
fCIty) (Stele)
MKIC Toayuan Tiawa n
and I rMkJed .L._ _. .Sh1MQILDey____C_01DIJll6~ion.._ ..- ...-, However, I h.ve changed my domicile
lit..... Ind .......)
t6 and am.nd have bMn.a bona fide resident of the St... of Florida .1t'Q____,..._2lat.______ ________day of
August ' .
_____ ,______. _____.' __________, 19.:..9.,J-d I r..ide It __.__128-,aoutb-.se.eond.st.--------
CIIrwt Ind NuMMr)
Fort Pierce St. Lucie
__~ ,__ __ ___ ___. _________ ___,______ ___________, __________ ,__.______..________________ County, Florid.,
. < (Oty)
- and this st.tement is to be taken .s my declar.tion of citizenship, ectual 1.1 r..1denc.e and domidle in the St.te
of Florida.
(1__ here ~ ........ flCll, euch . .... of ~ or -....-. 01 ........ldutlllll. of ........-.. .. *- ........
r-' of f--" Ie' _ ....... ~ of ,-, etcJ
Entering Kathe1een H King in 9th grade
" Bonnie J King in 9th grade
,91170
,,' '.~:; ,,:y~y..>::~ :"~ fllEO ANti RECORDED
, 'v .'\,v:l. ", ','... \ ". . A ~ DOOK
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: t\~;,,,,- .'1 ~~h";:rJ6i 'AUG 28 PM 3: '5
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_ '" (.-"".... --.\. ,~.., \~ ..-" r-\~. l.J L. R PO ITRH"', lo ..
". (/c ,.,...... ~ '" ..'. I { LUCIE COUMTY flORIDA
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I RJRTHER catTIN that I will ,~Gtw at my lout eddr... WMt\ the regi$tT.tion boob reopen, end 0mpIy with
"I other requlr.-menll 01 . Iegltt reaident of !hIs St.te,
I RIRTHER aRT1fY that I he..,. no intent50n fo retvm to my former domicile, and t InMnd to remain In______
.
.
__________F~.Piar~---------------------- .
~
s.t.L.\lC1tL____________________ ec.unty, Florida,
permanentty,
~ '; ~ ./ .
~~--~--
---..------------------------------------
~
, -~th" August ' 61
Sworn to end wbKrlbed befont me..... ,r "..,"......:>JI~ of _~_._ _ _______~-~ -------------, 19______
- ...\\" ~.... "_' .. /.111, ' ~_--4.
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______________________________.,___,_.:~;,~/:;~:;'~..~ J-, ~ <;:~~_~ ___________~_____________
ROGER F'OlTRAS, ClERK CIRCUIT ~~" f,j"'" "'V~ '-:;. ',--.--- Not4ty Public
~,_ f..J:' " ... ,<6-': ' ..,......... Putlll-c SUit" of FINida at Lare
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:::.,.., . -' ,:. ,: Uy "--,''''*'^n Ext'>irK Jan. ,
By ,_' .' ..;.11" I~_ . ... .......n"........, "', f'ft f W V
________________,_________________~,.....' H~_Mo..' eXplra ~.Oy~D ~U(UYJCXI'p_.r" .
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(\'e M ___ fa ...... -' " ~ c..t. .. .... will Tee '--"
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