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~ ~ Declaratio~ ot Oorntctla and Citisenshlp , '
TO THE STATE AN~ GOtJNTY TAX ASSESSOR, 132950
s~, wciE cout~nr, FIORICA:
This is my declaration of Oomkile and Citizenship in th~ St~t~ of Florid~ thst 1 am fitin4 thit day in ~oootda~os and
in aonformily with Chapter 22Z, Section 22?.17. Flotida Shtutes.
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I was formerly • lagsl resident of Franklin ~ P~.nn
Kity) (Sta»I
and I ros~ded at 1322 Pearl St ~wnror ~ have char+qed my domw~~
(Strest uid .Numb~r)
b~nd am and have baan a bona fids resident of the~Stats of florid~ st~os 26tb day of
f ~
' Ja~aury 19 65~ q03 B Ave` M
(Stre~t and Nun?bsr)
FORT MERCE, SAINT WCIB COUNTY. RORtOA .
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and this slatement is to be taken as my declatstion of citis~enship, ectual le~al residsnos and domidle in th~ Stat~ of Horida.
(Insert hera any pertinent fact:, such as sale of properry or butiness, or rolinquish~qentbt employn?snt
at former domicils, rsmova) of family to new domidle, purchase of home, ek.)
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kntering chi2~-in the public school ~
~ 132950 ~
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-A REC DED . ~ ,:~~'.a'~~ -
t' dH~~~~ 800K ' ~
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~08 ~
1965 FEB -1 AM ' '
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ROGER POITRAS. CLERK ~ . ' ' ' =
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Y. ftORiDA ' ~ •
ST. IUCIE COUNt .
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1 RlRTHER CERTIFY that 1 Wili oomply With ~II ofi~ ~equl~b of a tpal e~td~nt of this Stats. <
. 1 FURTHER CERTIFY that i have no intention to retun~ to my former domidle, and 1 intend to remain in FORT
PtERCE, SAtNT LUCIE COt1NTY, ftORIDA, permanently.
! ~ ,.`~~,;,,wnui;iir',,`,;ij~, ~r -I> _l-ze. l.~/,.1~«~.~~~,,~<<<-`c~
G~11.~ C e,~~~ (Nsmsj
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; Mra wiili~ua Beach :
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ta.+n~i~wbsaibed bsfor~ me thh lst February 19 6a ~
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;1 ROOER rOtTRAS . .
. ~ CIRCt!!T tONRT '
` ~ Notary Publk . .
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- AAy Gommi~slon ucptros
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F Re b~ ~x~arhd in d~plieah aed ~i~i~l ~:wMa Cl~t+ri1 , s~d ~
~ d~piiaN wwb Tax J1sMw~~a
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