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. pub - ~i ' and Cihzs~ship
TO THE STATE AND COUNTY TAX ASSES54R, -
ST. LUCIE ~~, apR~
This is my daduetbn of Domicile and Citieenship in tM Stab °~ Fbrida that I am filing this day in aooordana and
in conformity with Chapter 244, Sedbn 2Z~.17, Florida Statutes.
IIB~II ZOR1C CI'1? ~ 21 ~ N . ? .
1 was formerly a Ipal resident of--------------------- ----------------• ------ p,,,.~ ------
. 222 $'' ~lt3t St• ------:__-. However, 1 have dlanRsd my domkile
and 1 resided at -------------~ «+r N~~baf M ------ ,
------------------ day of
to and am and have been a bona fide resident of 1M State of Florida-sins___-1 ~ --
1QI- Celeatia Crt.
JUL? __-. ~q_ ~ ,and 1 reside at -----------------
--------- .tea ~«~..~
Ft. Pierce 3t: Lucie ________________ county, Honda,
and this statement is to be taken as my dedaration of dti~enship, adwl legal rosidenoe and domidle in the State of Florida.
pnwrt Mr• aw pKlin«M f.d., wd. w wb d proP.NY er bwli~, « erfM~P~~ ~ ~""d a fonw.r domivM.
r«wwd d f.miy w mw dowiklM, Puie1~. of Iww4 Mcl
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1962 JAN 26 PM 3:03
ROGER POITRAS, CIERK
fit. LUCIA COUNTY. fL61tIlA
. se Ck~"
1 FURTHER CERTIFY that I will rpis>>K at my local address when the registration books reopen, and comply with all
other nquiremenri of a ~' asident of thb StaN. ~ -
1 FURT'Hgt CERTIFY that (have no intentbn to return b my fomur domidle, and I inland to remain in
- Ft• F3iR'4~ St. Lucie County, Honda,
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«• ~&w ~Vbed bpf°r° me thls_ ---d!y ---'----~-~ - - ---
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~' •,'R •. `~ f •Sa~-~~ . ~ CIRCUIT COUICT - . _-~- -- buy Pubik
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