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Decl~ratton ot Domicll• and Cit~~~shlp
1'O ~ STATE AND COUNTY TAX ASSESSt?R, ~ , , '
ST. U1CIE COUNTY. FlOR10A:
~ Thi: is my d~du~tion of Oomidl~ and Citi~e~htp i~ th~ St~» of Fbrida that I am fllinp ~thh day In aooonla~a a~d !
ir~ oonfamity with Chaptu Siction 442 ;17, Horida St~hitp. . ~
. f w~s fam~rl a 1 1 ~"~~'~C•ct/~.~ ~ ~
. r ~ ro~'t _
~ (Gty) (Sab)
and t rosicled ir ~Cl~..[~.~~t~+ L~~ Hovwvw 1 haw ctwnped my domWit
' ~ (Stra~t and MumbK) .
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k. to and am and Mw been ~ bo~a fido ~skkM of thf Stat~ of Fbrida sina day of
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19Se=., and I rosid~ at
(Str and Nu ) .
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and this :tsterr~snt is to bs taken as my dsduatbn of dtt~nship, edu~l leqal ~~sideno~ and damtdl~ in fhs Stat~ of HoNda. •
pn~rt hero any pertinsm f~cri, wch as ~le of propsHy or bu:inets, vr rolinqui~m~nt of emplaym~nt
st formsr domidls, ~emovai of family fo. nsw domkil~, purcha~ of horne, etc.) .
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~ . , FtOGER POlTRAS. ClERK .
~ . St. LUCIE COUNTY, FLOftiD c
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~ 1 FURTHER CER?!FY that 1 will ~
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+ alt othsr roquire~r~s~h of a Ipal roside~t of this Stat~.
~ i ftJRTHER C:ERTIFY thst 1 hava no intentian to r~tum b my formsr domkilt, and 1 Intend to remsin ie fORT
PI~, SAIMT LUCIE GOUNTY, fL0ltI0A, permanently. -
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