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i ~ Declaration ot Domiciie and Citisenshf I
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1 TO T11E STATE AN~ COUNTY TAX ASSESSOR, . I
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? ST. WCIE COUNTY, FLORIOA: ~ i
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! my detlantion of Oomicile ~nd Citis~nshtp in th~ Stat~ of Ftorida lhat 1 am fili~q thi~ day in aooord~no~ and '
i~ conforn~try wlth thapter ?72, Sectbn 22~.17. Horki~ Statuta. ' I
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i ~ 1 was formsrly a Ipai rosident of Q~ • '
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i ~nd 1~ided s 1~brvwN 1 h~w tha domidl~
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~o and am and haw bean • bona fide resid~nt of the State of Florida :ina dsy of
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j • l~ORT ~1ERCE. SAINT LtICI! COUNTY. fLQRIDA ~
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~ and this :tatemsnt fi to be taken as my declantion af dtfzenshlp, actual lepal reside~os end dom4dl~ in ths Stats of Horida.
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~ qnsert hero any pertineret facK, such ~~ale of propshy or bu:ineu, ar nlinqui~ment of employmant .
~ at famer clomkils, removal of family to new domidle, purch~s~ of hwr~e, etc.)
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. ~ : E ~i-~' - ~ ' ~ F~.EO AND RECQ - ~ ~
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~ ~•-1 i';; ~ ~o ~ 1954 AUG 24 AM ! I: I S ` .
! R06ER POITRAS. CIERK ~ . .
} ~ " ST. LUCiE COUNIY. flOR10A
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1 fURTH~R CER'ftFY that 1 wl!! ~y ~ ~
r all other roqui~en?ents of a lepai resident of this State. ~
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; I fURTHER CERTIFY that 1 have na infention ~o raturn to my formsr domkjls, end 1 lntend to rem~in in FOt~T
~ PlERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
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(Add )
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~ ~ G~ ~!1.~''+o~ s~~d b.for. m. tias dey of ~ 19,.
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~ N~ary Pubik ~
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C. My Gort~is~ion ~xpires
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R~ b..vo.c~N~l i~ d~pN~a~ awd er1~i~.1 ~.d wili~ Ciwk c~uk C.wt, aad ddpNW/t wMM Taoc As~..N~,~
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