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18 PACl526
Dedaration
0.1:
~{lO'
ot rOtdidMffblid. Citizenship
TO THE :>TAT[ AND COUNTY TAX Ass.E5SOR,
St. Lu.cie
COUNTY, flORIDA
This is my declaration of Dorrll<ikl and Cilizemhlp in the 5tate of florida that I am ftlj'lg this dJiY ,,... occordlln<.e,
and in conformity with Chllpt1!tr 222, Sedion 222.17, Flonda 5'ahJtes.
I was fOfln.erl.,. .. lega~ resident of
Ami tyville
New York
(City)
($I..,..)
"nd I resided .-f
111 Bryan A.venue
(S"._ ..,.; NvmboI.)
.........,wev&r, I have changt'td my domicile
10 and arYl and have be&n a b.,n. kie r&sldenl of the Slllla of Fiorida since
16th
day of
September
. 1961 ,and I reside at
e15 South 12th Street
(51rH' .nd Nv",bot.)
Fort Pierce
St. Lucie County
(Cify)
;:)t. Lucie
COU'11y. Florida,
and this sfaf~ment is to be taken as my dedaration of citizenship, actual legal residence I!lnd domicile in the State
of Florida.
(1_ ~tI ....." j>ert!........1 fec:n, wdl .. ...... crt I"operty IX bww-.. O' r..Unqu;o/1JT;enl of _ploy men! a! fO'..... domk:j~,
,..",.,.".1 of f-.ily ~ _ domlclle. purcNc. of ~. .Ie.)
Diana Rae Sothern in the 12th grade
William Martin Sothern in the 10th grade
Pamela Jean Sothern in the 8th grade
"......
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I FURTHER CERTIFY tkat I will r.gitfef at my loc~! add"lJ'H wh.n the regi$traHon book:s reopen, artd comply with
an other reqviremtlnts of , legal rMldont of thi, $tato,
fURTHER CERTIfY thet I h.'i~ no irtention to
rlll'turn to my fo.nn.er cl~rr:~c~le,.~n.~~f\. "~.nte.._nd. to rema;r.' in
, '~--". ;:; t' Litc"ytt "- Covnty, nonce,
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18th.,
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dl!r of-
';9
ROGER f'O!T~AS, ClEIKK CIRCUrr COURT N.."~l'P~1 Pl.ibk
By . ':to/~_d'~~.,. O.C My Comm;$~lon e~pif.~
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