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Declaration ot Don~icile and Cittsenship ~3,2518 ~
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TO THE STATE AND COUNTY T/1X ASSESSOR, '
Sl. LUCIE GOUNTY, FLORIDA:
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This i: my declarattor~ of Qomidl~ and C1tlz~~ship in tM Stats of Florida that 1 am filinp thi: day in aooordana ~nd
in oonformily with Chapter ~22, Settlo~ ~2Z.17, Florida St~hdes.
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1 was formsrly ~ lsqa! mstdeM of Clevelitnd ' Ohio ~ •
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~~nd 1 hsidsd at 3271 West 13,'~th ~ Horwver I hav~ d~arpsd my dornl~il~
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b and art~ ~nd have been a bons fide resident of ths Sfa~ of Ftorid~ stnos ~ath day of
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~ November ~q 64 , and I~~de ar 619 ~oconut Ave. kiver Park
. (St~e~t snd NumbK)
l~ORT M~C~, tAlNT LtIC1E COUNTY, RORIDA ~ , : .
and this statenw~t is to bs taken as my dsdsration of dtiz~nship, actual le~al residenos ~d domkils in th~ ShN of Horida.
(Insen here any p~rtinent facts, such as sale of propert~r or 4usinsss, or rolinquishm~nt Of.~nnploym~nt `
at former domkils, nmoval of family to naw domicile, purchase of Fwrr~, Nc.) _
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~stsbli~shing residenc~ ;
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132518
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1965 JAN t 4 . . 1'•
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R06EFt POITRAS. q.ERK = ' ; w ~ . s ~
St. LUCIE COUNTY. fIORIDA , _ ~ : ~ ~ ; ~ :
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I tiJRTflER CEltTIFY th~t 1 will aomply with all oth~ nqui~fs of a Ipai ~id~m of M~Is Sta».
" 1 FUR7HER CERTfFY th~t I haw no intention to refum to my formsr domWie, and I i~tend to remiin in FORT
: WERC6)~9KIN'F..~CIE COUNTY, FLORIDA, permansnNy.
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1: • ~'~p= _i - m.~
_ = ~ ~ : : Harry L. Grove -
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~ Swor~ b a~d wbstribsd befot~ tn~ this 1~4th Janua~~ 19 bs ,
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(Ti b~ ~oaal~tl M d~plka~ ~«i~Mal f~d wi~ Clwlc CMaiM Cw~~, an~! d~lieaN wM~ Tavc Aw~~
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