HomeMy WebLinkAbout2763 ~'y ~ ` .~~...r--- .~......r~- ~ :
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Dacla~atlon of Domictle and Citize~ship ~28666 ~
TO THE STATE ANO COUNTY TAX ASSESSOR,
~ ST. WCIE COUNTY, FLORIGA: ~ '
This is my declantion of Oomicile and Citize~ship in ths State of Horida that 1 am filin~ thi= day in aooordano~ ~nd
in aonformity with Chapter 2Z~. Ssction 222.17, Florida Statutes. ~
1 was formerly a leqal rosidsnt of 9haw Airforce Baee q-~-
(Ciry) (Sfah)
and I hsidsd at - . Hovwvsr 1 haw cha~.~sd my domW~~ ;
(Street ~nd Number)
b a~d am and have been a bona fide rsside~t of the Staro of Flalda :inos ~Y ~
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~ ~ . 19 , snd 1 r~ide at 211 Nerth 2nd ~a .reet ~
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l~RT NERC~, SAtNT LtlCI~ COUMY, RORl~A
snd this statament is to bs taken as my declaretion of citizenship, actual legal ~esidence and domidle in th~ Stat~s of Horids.
(Insert hero any pertinent facts, such as sale of proparty or business, or relinquishmsnt of empioymsnt •
at tormar domicils, removal of family to new domicite, purchase of home, etc.) '
Returned from service 23rd of July , 19b4 , .
(ieof~ge C Layne r~nd family have been with the AJ~rforce for the laat
~ 20 ye~re~ and this la hia legal reai~ence ~
- -~z~sss ~
; Eatering Lana T~belyn Layne in the 6th grads fl a~p gE~Q E~
; ~ IK ~tual Reco~
~OOK
; 1964 SEP - ~ .
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i ,,~`~~~~T ~c~~? " -Deniee Lorraine in the 8th grade M 9• OS
~ ~ ~~~c• - AOGER POITFAS CLERK
ti~ ! y~ ~ : j'~ :
ST. LUCIE COUNTr. FIORIDA
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I RIRTHER CHtTiFY that 1 will oompiy with all other roquT~~K of s Ipal ~ident of fhis Shts.
; I FURTHER CERTIFY that I have no intention b retum to my former domicale, and 1 intend to romsin in FORT
PIERCE, SAINT IUCtE COUWTIf, RORIDA, permarrently
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~ ~ 4 ~ ~ ' X lst 8eptember ~q 64
! Sworn b and wbsaibsd befor~ me tfiis dsy of •
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a RORRAS . ,
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