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TO THE STATE MID COUNTY TAX ASSESSOR, _ .: • ' ~ ~ ..
• - _,
St • Luria COUNTY, FIORiD~A:
This b my dedaration of Domidle and gtiaanship in thi State of Florida that 1 am fllitp this day in aooondanas,
and to conformity with Chapter 444, Section 242.17, Florida Sfatuhs.
. 1 was forrr~ariy a Ipal resident of_________~ffi1~____--------------------. --~i11<N1•_________--
taM O~i
9S5 _Paarl Street ~ _ Howwr, l haw ~„~ n,y ~,~N -
and 1 resided at--------- ---------------------------------- --•
tittwt ad Nu~~b~t) .
to and am and haw been a bona fide resident of the Stab of Honda sinoa_____~Qt~_________________day of
----Aaigt>ll~t_____________________• 19_~~_, and I reside at __~•~~ $1~A~14--~~-'--------------
----FQrt_4ietC~---------------------------• ----$.~.a_Lu~O------------------- ~+b• Florida,
lCMi
and this statement is to be taken as my dedaration of citiaanship, actwl legal resldenoe and domkile in the State
~of Fbrida.
pnNet Mt. t+q patiewot fast„ tud~ a< ~.i. of property a bu~~w~, a roMn*iYwik et .~i.TwwM M totw~ ~oskib.
nnwnd d tar+My to nw dowtell., purdw. of IMw~..t~e.~
Purchased new home located at 1130 Stmriaa Blvd., St. Lucie
County Florida, more particularly described as follor~rs:
Lot 28 Block 2S of PINEWOOD, as er ppl,at
of said Subdivia~on cit. file in the ppuublic
. records (Pl>iit Book S, page 24) of St. Lucie
County, Florida.
1013'70
QED AND tECO~ OS ~ ~ .
' ItL ~.!°
_ ._.
. ;~~~ '• ,'' ~ .. • ~•;~ ;961 OEC 29 AM I I : 49
:~ o-:•,~ _. , ,. ~; . ~~ROGER POITRAS,CIERf(
~ ~ ~ . • * ~• ~ •~T. lnC1E COUNTY, f ORIDA •
* :. .~. ~ c Q.~
I FURTHER CERTIFY that I will register at my kxal addreu when the registration books roopsn, and con-ply with
all other requiremenri of a Is9al resident of this Stab. _
I FURTHER CERTIFY that I hsve rw intention to return to my former domkiN, and I intend to remain in______
-------~Or~_~'-l~s~ -------------------- - - -- ~t~- ~+~c~¢ ----------------- County, Florida,
IpM ,
permanently.
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a~a ~~L;
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__11~Q St.~lnrise_Blvd.._;.,±~.rrco=~'.,•,.,•
"AIL-- ~~ - ,,t, y !t ' •y~, '
Swoin to and subsuibed before me this. ~ __-- day of -- -- ~ "~ ~'1
- .~:, _
-- ~, _
ROGER POITRAS, CLERK CIRCUIT COURT i %-`
- i'• •'
BY ------------------------------------- D.C.. My Commiuion expires -- - ----.~+!~ ~~~
po M aaKM.~ in iAMnN at/ «laial ~ rr1Ai Cltrk f7rsoit Cwtf, at/ ttt+,itslt+ wr Tat Atarnrt. f
•~oo. rr. nuwa~