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- . . ~ ~ 1.. ~..v. «ti;~.~r~. ~ : .h ~ •t ~i j ~ 't, ~ v~~. . . ~ O~claration of Danlcit~ and Citizenship . . ~ .i3~c'65~' . TO THE STATE MID COUNIY TAX ASSESSOR, ~ . ~ ST, ltK1E COUNTY. FLORIDA; ~ ~ . - This is m~r decluation of Oomicile and Citi~s~ship io th~ Stat~ of Florida th~t ! am fllinq this day i~ aooordana a~d ~ . ~ ~ in aonFormity with Chaptsr 22~. S~ctb~ 222.17, florida Statutes. ~ ' 1 was formerly a Ipal resjdsr?t of - 8m~==a ~ Illieois • . K~ty1 . ~ ls~~») ~ ; ~ ~ _ 1734 No CaliforAia . ~ ~w~~ my _ (St~~et and Numbsr) b and am and haw bsen a bona fkN ~eslda~t of ths Sta» of Florida sina day af ~ ' . ~rch , 19.~, and 1 restd. n 2~Ob ~e~.~~e. (StreN ~nd Nurt+~) - /ORT N~CE. iA~NT tUC1E COi1NTY. RORIOA ~ " t and this statement is to bs taken a: my dedaration of citizen~ip, actwi lpal r~idsna and domidl~ In 1M Sht~ of Horid~. qnssn hers any -pertine~t facts, wch as saie of propery or bu:ineu, or nlinquishr~nt~of amploym~nt ; ~t formsr domidls, r~rwval of family to ~ew domicile, purchas~ of home, ~t~c.) ~ ; ~ Applying for bomestead 13265~. . _ ' . _ ~ . ` . GU I,T,~- i .•~,4~4'.. v ••••''Cp D ~ ' - • g~- ECOROE~ ; ; ~ L I ~ ~ ' ~ j . : : ~ ; ~ - ~ 600~, ~ ' ? : . ~ m ~ M ~ ~965 ~ ZD f117 27 ~ ~ ~ . , _ t _ . sROGER POITRAS, I~ ~ . . ~ -o . UCtE COUNtr, fLOR10q•~~-'~-~-~ I - ~ ~ . ~ ~ i] . S ' i - ~ • } . • ! I RJRTHlR CERTIFY H~at 1 Will comply with ~II ofiMt nqult~rrwnfs Of • Ipai f~id~nf of thb Sht~s. , ~ . ~ ' ~ 1 FURTNER CERTIFY that 1 have nc intention to return to my formsr domWk, and 1 l~tend to nm~M tn fORT ~ PIERCE,.SAINT tUGfE COUPRY, H.ORlDA, permanenlly. ~ . +~~~tiT. ~ ~o` ~ ~ ~l . . .-f.~+1 ~~s 9~! p ~Na " i , rthur P hook . ~ ' t t• ' ~ ~~•4 . . ' ~ ~ ~1 . . . tf ~tT~ ~ • ~ . i ~ , ~ ~a, \ . - ~ . ~ ~v " ~ . " . " ....~~...~o c.. Sw3tn~+~r~ii! wbsatb.d b.fon m. N?tt 20 ~r ~ Jaaaus~ 19~. ~ tORRA~ ~ , C~CWT Notary publk ~ , > . ; • t ~,~~i.~,GC..~• ~ • Of? O C. AAy C,om~r~issbR ~xpk~ c ! • . _ _ 1T~ b~ ~oc~aM~d M d~IicaN ~i ~i~Mal AMi wMl~ q~it pewiM Gwt, a~i ~~rilb Tas A~~.~ . : = . 109 E~10.4 . ~