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~~~~ 57 PAsr200
Declaration of Domicile and Citiztmthip
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'I'll T1H: :oTATE AND COUNTY T/,.'( ASBESSOR,
:0;'1'. LLt'lE COUNTY. FLORIDA:
Thi~ is my dedaration of Domicile r.nd Citizenship in the State of l'lorida th!lt I am filing this day in accord;\n~e
and in conformity with Chapter 2~2, Section 222.17, Florida Statutes.
I "';IS forlllC'rly a legal resident of
Battle Creek
( City)
:.llc hL;an
State
519
.;t:oks
;"ve.
. However, ! have chang~d my domicile
:1.I I I rl',jdcd at
t Street !II "I Number)
t" :01:.\ am lInd !lllve b(,(,lI a I>.,.,a fid(> resident of the Slllte 'of Florida since _
1st
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:1:t r. Box 1!d-1J
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l:l~ and I reside at
(Steet and Number)
FOt:'1' PIERCE, SAINT LUCIE COUNTY, FLORIDA,
w.! [hi" ,tull'llIcn: is to be tllken as my declaration of citul.'r.ship, actual legal rellidence and oomicile in the State of Florida.
(In'(>rt here any pertinent fllcts, such as sale of property or bUlliness, or relinquishment of employment
at former domicile, rcO\oval of family to new domicil.', purcha8p. of heme, eic.)
113289
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I I.TRTlIEH CERTIFY that I will regi8ter at my local address when the regi8t~tion books reopen, and comply
'.':it!: all o,lht'r requirements of a Icgal re~ident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend t<l rem14in in
FCRT PIE/WE, S:\!:--iT LUCIE COUNTY, FLORIDA, permanently,
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/~ (Name)' ./
JeoDge Lc Tyler
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:-"::,':'n :n aL': >ub,;cribed bpforp. me this
1 Q t,~< day of _.___
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(T" he cxecut('d in duplicate snd orlginsl flied' wlth\ a.rtI Clr;clt Court, ami duplicate with Tn A~or)
1:()(;r:R POiTRAS
CLERK CIRr,UIT COURT
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Notl!.ry Public
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63