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De~larotion of Don~itile and Citizsns'hip
•
TO THE STATE ANO COUNTY TAx ASSESSOR, gb~t ~7 X417
Q,~_ T.uni ~ COUNTY. Fi`ORIDA: - -
ST. LUCIE COUNTY. FLA.
This is my declaration of Domicile and Citizenship in the StaN of Florida-`iliac-1~ sm~np t-hi: dsy In acoordanos and
..`
in conformity with Chapter 222, Section 222.17, Florida Statutes.
was formerly a legal resident of__________~=8-taltbD~1411.Ia---------, ---Dhia------------=
(uh) ltaata)
and I resided at -____-- ~''f2--Yirgiifli.a-Lgentie-------------------. However, 1 have changed my domkile
(it...t and t~Atdtat)
to and am and have been a bona fide resident of the State of Florida since_._____11th___________________ day of
-------------J~__________-_____._____._-. 19-bL-, and I reside at ___--141--Cgs-tans-C.ou~t-----
(31ra+t and tiumtfar)
Fort Pierce _____ 3t. Lucie
-----------------------L------------------ ------------------------------- ~-nty, Florida,
(City) -
and this statement is to be taken ss my declaration of citizenship, actual legal residence and domicile In the State of Florida.
(InaKt tan aMr pa,tinant iacM. wd+ as wN of p.oparty or businesses. a nlinqubhwunt of amploymant at former domiciles.
resmoval of family ro nesw domkiles, purchesses of homes. estcJ - .
$stablish residency for homestead purposes.
1~ )i~3~33
~o ANa RECOROEO
~ ~900K .-; . ; :.
1962 JAN I S AM 10:28_ ~~ ~~ - "~a=. . _
.,:
- ~~ ~,.~' ';gyn.
ROGER P01?RAS. ClE ~ =~•
St. LUCIE COUNIY, Flo ~A-.':.~'-~-',~ , ',
'~1~1. .- ~_ , - _
I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and comply with all
other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have tto intention to return to my former domicile, and 1 intend to remain in
- --- -- - - -~OS.t_~IIZCt3.- --- - ------ - -- -- - - - -- ---.~.t.,_~+]~t-Ci~ ------------- County, Florida,
. ~,~ r ~ (City)
rm 'e}titl ' ~~'•
Pe. ~J Y• • ,. ~.'~
~~
# :. u •- '~ ~ ~ -- (Names)
•w :. 1~ - : ` ohn B-. HCCasTin
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Swom~'toasnd~wb3ctibed before me this-----15~h_ _ __---day of _____-__-.~IBriutaT,y__-- ____-- _ _ - , 19__42
- -- --- ~~: _ -~~cf-- -------------- - ------------- -- - -- -
R ER POITRAS LERK CIRC IT COURT Notary Public
OG ~
gy _~~--- - _ ~•,Lv-- _ D.C. My Commission expires-------__--- ---------------
(Ta M uoescesses/ is dgliraeses said arieiaesl fYesd ~ Clesrk Cirerit C«wt, said dgaeases ~raU ia: Aesesessaesrt
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