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: . ~ Decla~Ation ot Domlciie ~nd Cltizenship
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. t TO THE STATE AND COUNTY TI1X /1SSESSOR, ' '
ST. Lt1CiE COUNTY.. R4RIDA:
This is my declantion of pornkil~ and Citisenship in th~? Sfab of Horid~ that 1 ~m filirp fhit day in aooordana ~~d ~
: in oonfo~mHy with ChaptK 22Z. Ssttion 22Z.17, ~ida Statutes. .
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, 1 wss fonherly e lpa) rosident of Qie~er (~9O~~a _
~ (CEy) ~ (Stats) ,
and I rosid~d at ~ 1 Hnwwer t have chan~ed my domWle
t t~eet and Number) '
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• b and am and hsw bsen e bone fid~ ~ident of the State of Flwida si~os 1~ ~ day of ~
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F'ebrttatg 1S~_____, and 1~ide at 1008 ~iro C . '
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w~rr n~x, s~?a~ wcte cout~rnr. aoRro~
. ~nd this statement is to bs hksn as my dedantion of dtirsnship, ectuet Ispal reside~oe and domidls fn ths Stats of 'Horida.
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• ~ (l~ssrt hers any pertlnsnt facts, such as ssle of prop~rty or business, or mlinqufshment of emplo~yment .
at fionnK domidle, roRwval of fannily to new domidie, purcha~ of home, etc.) '
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E~tering Clarence Bvyd Jr. ia the 8t~? gra~de ~ ~~`7~ r
~ * Barbars iLline in the bth grade -L
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_ . . ¦ Charlea in the lith ~rada /~a$ ~-r„ ~9 - $~Q~ . ' . ~
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i fURTHER GER'TIFY t(~st 1 wiil compiy witb
' ail ofite~ tequirements of a Ispal rosidsnt of this State. ~
: I FURTHER CERTIFY that 1 have no intention to mtum to my former domidle, end 1 int~snd to remain tn FORT
' PIERGE, SAIWT LUCIE COUWTY, FLORIDA, permanently. •
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8ss~el Bayd~~~
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(Addtess)
Swom ro and wbscribed before rrk this ~~L day of Februarsr , 19
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8~? D.C. y~~y Comir
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= ~ Re b~ ~oaeutad M du~al~ and original fq~d wiM~ t~e~it~a~ait aed ddpliat~ wttl~ Tax Asas~ora
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