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Wi 18_83
Dedaration )bfl~~Ul rb~' Citizenship
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TO THf Sf A TE AND COUNTY TAX ASSESSOR.
.S..t......_Lu.:.i.tL__.__uCQUNT't'. Fl~IDA:
Thil IS my dGcl.r.tion ot Domicile and Cifu:.mship In the Stete of Florid. flwt I em filing .hil da:y in ~.nc:e,
and in conformity with Chapt.r 222, ~ion 222.17. Floflda St.:vt_-
I w./t$ formerly , It:gal resident "f
_ Winston S.alem
N.orth Ca.,rolina
~~l
(Cllyl
and I resided at.
448 Ir\.ring$treet..
(StrN' ...d Nuonbul
Howe-ver. I havo ch.,~ my domicile
to and am and hav.~n a bona fide resident of the State of florid. sinrA._
13th,
cloy of
n.rtn August
, 1961 ,and I re4ide at
311 C Pr~~tQ~L~ourt
{$f.... IInd ~l
Fort Pieroe-
(c"",
,~:tt.t L~c.j,~___ -. -.. .
_. County, ftOf"lda,
..nd this stet.ment is to be t.ken a! my declar.tion of citizenlhip, actual 18',).1 retiderlCe and domicil. in the State
of Florid..
(1_ ..... .ny pl'ttlMM feeh, well '" MIe O<f ptOptrty ~ bv.In9n, Of r.llnq..w-.m of ~, ., fotmet doMk'Ie,
t.~.1 of f......ily 10 ........ dom!dle, P\if~ of Mme, ~)
Change of residence
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V 1:1' \\~D f~CQ')OEO
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Official Recorl'~ .:K
b ~"If\' L \
,951 :E? -~ IV. \,
ROGER PO\TRAS~ ~lfr~,
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J71)
I FuRTHER CERTIFY th~t ! will reglr.t\!lr ,It my loelll ~ddr~'P whl'tfl f~ r~i$tfll\ion boob re-open. and comply with
all other requirements of II !e<Jal resident of this State, '
FURiHER CERTIFY that i have no intention 10 return to my former domici,e, and I intend to remain in
fOl't ,Piercc;_
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!:.?()(:;tR P()l~'~:A::,~, CLERK Cl,~CU!T ('i.)U~~l
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