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OedaraHon of TOOWl1SUllFWtiA'Citizenship
TO THE STAn AND COUNTY TAX A.55fSS<.)w,
40_'~ T. LU l.:-J ~,~
COLiNTY, nOR!f>A
This it my ,-je--..:llIr~tlon of Dornici\.e and Ci'lzemhip lI'l the 5to!lle of Florida thaI I am filing this dlly in .,('(o,d"nce,
ar.d in confof'l'1ity with Chaptt!tf 222, Section 222.17, Florida St.,:utes
WlIS for~rly " leg.,1 re!idenl of
ASH l~AND
KY.
(Cry)
(Sla19)
and I resided at
2901 Carter Ave.
l1t- And Nv.nbet)
However, I hlwe chol'l<J&d my domicile
~ ~PT ::1,:[ ~.:~R
61, and I reside al
1 st. day of
s. Federal HiGh~ay
2)00 ~~erene Tro.ilor Fark
to and am a~ have be-;,n a bon., fide f!inident of the StMe of Florida iince
, 19
(SIr...' lInd Numbt<)
FT. PI :SRCE
ST a. LUCIE.
County, Floridll,
(City)
and this statement is to ~ taken u my dedMation of citizenship, actual legal residence and domicile in tne Stale
of Florida, ...
('f\M(' her. enf pe<"....., f_. aud! .. wi. of p-operty Of btAinona, Of r.linqul~ of ,""pIQy~' el 10<..... d.>rnicile,
removel "f lemlly to _ damkil., pvrct..e of holM, ~l
u:n:.RIt\G o!;E CHILD IN PUBLIC SCHOOL
;.:ARY EVELYN SI-liTH
l2yrs
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'~,Ii OIfttJiL~ 1,OOK
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I FURTHER CERTIFY that I wiil re;iI.rOf at my i<X.&! addrft$~ when tho ,e>tJ'ltrlltion book~ reopen, !lnd comply with
all other r~ifel'fl4llnt5 of oi\l i4!l9ai rMidenl c:f this ~t.t....,
FURTHER CERTIFY ~f i hlive no ii1t~lirion to r~hlm 10 my fOfil'l-ef oomide, end intend to rem<!}ir. in .
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PIERCE
ST. IJ.JCIE
C;,vnty, Fiorid&,
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(City'j
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Slti'.74'f1 ~v ~nd $'~p$>crlber,-j tx.fOfil' ,-r;l\\ th,1-
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dillY of
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C1 f(~:~,~;f)RAS< CLERK , :ur: ((;"JRl
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My COl'!',!"'W;,:>il:.n a-.;pjr~$
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