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~~ ~~ 27 PACE6 1 .
Declarotion o~,Dq~i~~~~ri~.~ Citizenship ,
TO THE STATE AND COUNTY TAX ASSESSOR. ~
St. Lucid COUNTY, FLORIDA: _
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of _ _ .. _ _ _ _ _ _ _Flint Mi Chigan
(city) _ (Sub)
330. Odette Street `` _ _ _. However, I have changed my domicile
and I resided at --- ----------------- -
, (Street and Number) '
to and am and have been a bona fide resident of the State of Florida since _.. .. __ 1-~t~l_ _ _ _ _ _ __ _ _ _ _ _ _ day of
April - _______-__, 19.1 , and I reside at __._ 1~1_ Estia_Lane____=____
_ - ---- ~ (Street and Number) --
Fort Pierce
Ste . Lucie_ County_________________ ____________Ste_Lucie____________ county, Florida,
(City) -
and this statement is to be taken as my declaration of citizenship, actual legahresidence and domicile in the State of Florida.
(Insert here any pertinent facts, such 1s sale of property or busineu, or relinquishment of employment at former domicile,
removal of (amity to new domicile, purcMse of Aern., etc.)
Est:~blish Residency
a~ RECO~DEo
~~~ ~o -- ~o _~ooK
1;61 Jule I ~~ PM 3: 24
RGCER P~i7TibS.LtEfiK
ST. LUCIE COU;1.;Y~t~Ipp
c~~
~~•,•
I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and comply with at)
other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
Fort Pierce
St. Lucie County St. Lucie county, Florida,
(Gty)
permanently. -
(Name)
• Arthur V. Brewer
(Address)
Sworn to and subscribed before me this 1$th day of J 1nl1aY'y ~ 19 62
ROGE2 POITRAS, C~l/E~2K CI UIT COURT Notary Public
By %~~; ;Z~~CL D.C. My Commission expires
(Te bo execehA ie duplicate aw/ eri~iwal fife) veitk Clerk Circwt Cowl, awJ doplicab w+k Tax Aswssor)
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