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Declaration of ,.; ~ !~ '~~~~,1~~ ACitizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
St. Lucie 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.
Winter Haven Florida
was formerly a legal resident of___ ___-_--- -__-_- -- -- --- --- -- ----------------------
- - r (Stab)
(City)
and 1 resided at _ __ __ _ ?Ol_AVenu@ N.,.. N,,__E,'''_ .- __-. However, I have changed my domicile
(Street and Number)
Fort Pierce
to and am and have been a bona fide resident of thefState of Florida since _ _ l~th_ _ _ _ _ _ _ _ _-_ -- _ -- - - - - day of
_ 19_~-,and 1 reside at __I~arltOn_Bandh---------------
---- ~ ------------- (Street and Number)
-- -- - --Fart_~iB.~ec~------------------------
(City)
~~ T»~i g.___________.___ County, Florida,
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Iraert here any pertinent (ads, such as sale of property or business, a relinquisMnent of employment at former domicile,
removal of family to new domitik, pwcMse of horns, etc.)
Entering two children in Public School:
A. Edward Lounds III in the 11th Grade
Linda Louise Lounds in the 2nd Brads
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~p AND RECORDEnoK
It~~ . __.
1962 JAIL 1 ~ Pti ~+- ~ I
ROGER pU1f IZAS~ tit~~
ST . IUCIE COU'~~ „i~ !,
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 no intention to return to my former domicile, and I intend to remain in
_ Ste-_I+uCfe__ ___ __ __-__ _-_-- _ .County, Florida,
. -- - _ ._For~.Eierda-- --- --------- -- ---
..,.. (city)
,ti i. ~
permanentl~o. - '~
- .......
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.. .rte
~_;. ,
~r, • ------- ---- - --- -- - --- ----- ----
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Sworn to and subscribed before me this ____ _ __ _ y - - ---J81111A2'Y - ~- - --~- -
ROGER/POITRA~SiCIER IRCUIT COURT
sy - -- -------
------- -
Notafy Public
My Commission expires..____.-____- _ -.- -----------
(Te M exe.le1 b +.~Ikr...d erl~inel filed ~ritV cMrk cMs.i. Cw.b ad +.rliceew. trit- Tex A..ae»)
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