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Declaration g . ~u i~'~~~~Y°~~• Citiza~:hip
TO THE STATE AND COUNTY TAX ASSESSOR,
$t•LuCie COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I ~ m filing this day in accordance and
in conformity with Chapter 222, Section 222.17, Florida Statv-es. paw York
Clarence
1 wss formerly a legal resident of------------------------------------- ~)
(GM)
$ Q Craus Rd _____________ -_. However, I have changed my domicile
-------------
and 1 resided at ___ __4_ ----~~ ~ ~~)
da of
band am and have been a bona fide resident of the State of Florida since______~ ------------------ Y _
------------------- M8`-~-------------------, tq-_ 61 and I reside at 15_x-Castana _Crt z_ PorE -St • Luci
-~...~ .na t~e..i
-----~~~~~~ --- $tzLiicie ------------____-- County. Florida,
and this statement is b be taken as my declaratiwn of citizenship, actual legal residence and domicile in the State of Florida.
per.rt hw• eery p.rtirwe-t Bets, wd• as wl• of property a twat a n~MquAke~.eM of •mploye~eM d tarnwr do,nkil•,
rsmovd of famly b nsw donadM, purdrs. of lams, dc.)
Establishing residency
lU1'7S5
..~.~~ ~~~~ ., SOUK
;Y` ~ ~~ ~~ ~ oc--~~ D t: 39
~ - v ~ • ~~~`:; : ~ .1962 JAN ~ ~ P1'1
4G 0 NSY f
~~ • v' ~ ~v ~ iJo~'~_
I FURTHER CERTIFY that I will register at my local sddress when the registration books reopen, and comply with all
other requirements of a legal resident of this Stab.
1 FURTHER CERTIFY that i have no intention ao return b my former domidle, and I intend b remain in
Ft.Pi,e roe
---------------------------------
permanently.
Sworn b and wbstxibed before rrte
$t • LuCie ----_-- County, Florida,
BOQ~ffit POI?RA$
POITeRAS` , f~ERK CIRCUIT COURT ` i
-~; :,f,, Leonard M. H board
'~, fate«~#,~~.
~; ~'. ~ rat ' ~-+~- -----~~ ' Publk -------------------
tr. w •....~d v +~r...at wyrarl M trM pstt ~ ~ 4~ .rah Ts 11...aa1
•~se, n. ~•ssos
--. _._~..~.- ___ __ ... __ --- - -~---- -- --_~ _----_._._____ ...- ~~...ty. .E.,._..,..._..__...,_....._._-_..~....._..r.. _.~ _.---.._.