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Dsclarotior- of Domicils. and Citizenship
AND t:OUNTY TAX ASSESSOR, 9b~~ ~ PAGE 458
TO THE STATE
St. Lud a oouNTY, FtORIDA: ~ ~ ST. LUCIE COUNTY. FIA.
This b my dedaration of Da+nidN and Cite in the Stets of Honda that I am filing this day in aooordanoa,
and in conformity with Chaplrr 222. Section 222.17, Honda Statutes.
H--- ------ ~-----------. ~+e<~~.~hks~4~~s--
i was formerly • Neal resident of_____-- p~.t
2~9 Bridge_Strest _____-__-. However, I haw. changed my domkiN
and 1 resided at------------------ -------------------
13a.~ a~/ Numb..)
------------~Y of
to and am and haw bean a bona fide resident of the Stab of Honda sins-----~---~ ----_
December __ 101_Cel~eaane ~«i ~ ------------
------------------, 19_ 61 ,and 1 nsWe at
=--~tar~_3.~.-lucie~~azt_Pisr~cs------• ----------5~._J~uui-e------------ County, ~~•
and this statement is to bs taken as my dedaration of dtfaenship, adwl lapel reskfanoa and domkile in the State
of Florida.
pnMrt Iw. aw p.r~MMt f~ wd .s wM of p./mM w biwMwb ~ nIYNi~i~mMy ~ ~"'~"~ M ta~ww d.mklb.
ew~wd .f t~mMy to new i~idMr Pw'~~ of Im+~, Mul
Watering Beverly DaT in 6th Grad•
I o , ~,~' o
~ ~~
1961,IAN -2 AM 9:44
r
:=4°1,.•-~:-~••.:~ "~~~ ROGER POITRAS CLERK
- ~ ~ . ~p :~ +~ s• ~ iT. IUCIE COUNTY, FlOR10
~~
r't~ ~~" •:;fit'/.~ ~ ~ • -
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I RJRTFIHt GHtTIFY that 1 wql register at my loesl iddrws when the atbn books reopen, and comply with
- all otMr requitwnents of a Neal nsWetM of thb Stets. ~ .
1 RlRTHER CERTIF1f that I hays no hMsntbn to restore b ~ fotmar doirAdN, and 1 intend to remain In____--
- iron Pierce _ --------------------: - = --------St. Lucie------ County. Honda,
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P1~• - y~QQc4St-_ ~- -------------
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- - _x__H.,~,~..I,r-----------------
-. ~ - 62
Swont /b and wb+aibsd brkr~ ano the - ------- -- - ----"- "------- _
. K C1>~IR QOUl~T ~,
_,......a``"~_~:_ r..-•~---_ ,~~C.. M~- Co~iaaieil '+~pira~ .._-..__-.....------- -• -----
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