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:1a33Q23 ~
Declaratio~ ot Do~»i~ll• a~d Cftt~~nshtp
TO ~iiE STATE AN~ GOUNTY TAX ASSE.CSOR~ vi~~R ~~O F~AGI
' ST. LUC1E COUNTY, FIORIDA:
This i: my decla~~tion of OornFcils and Clti~~uhip i~ th~ Stat~ of Florida th~t 1 am filinq this day tn aoootdutia a~d
in oonformity with Chaptet 224, Section ~42.17, Flortda Statut~. , ~
~
~ i was formerly a la~al resident of -~11et~~~k~c ~ Wi!~~p
s~in
K~b) (Sta»)
i wish to f
and 1 rostded ~t ?35 No 35th St. ~K~~~~~~ ~~~N i
(Stre~t and Nun~x~ ~ '
;
to a~eh~c~onhbrttz~e~ta~l~mf~Yf01!l~1~of]~t~e StaM of Florlda sfll~ dL~~bf
~ - ,
, t9 , and ~~atd~ n 4621 Hillbsook Dr Aanandale, Va.
.(ShNt and Numb~r) ~
4
!'ORT MERC~, SAINT WCIE COUMY, aoRmw - ~
i
•nd this statema~t is to be take~ as my declaration of dtlz~nship, actual. ipal r~sidenos and domkil~ in th~ Stat~ of Horid~. '
Ilnsert hers sny penine~t facts, such as sale of propshy or buiinas, or reltnquishrasnt of empioymK?t ~
at former domkile, removal of family to new domkile, purchs~ of harM, etc.) ~
bntered into the Service from Wisconsin, 1942
' Stationed at preseat to tbe peAtagon Bldg, living at present
in Annand~le ~a. , .
~ Wishes to declare Nla. as his reside~ce- si~ce he now owns
property in i.akewood r~rk - 133023
f11ED AN EI;p Ep .
~ ~ v,~ . ~~OOK
JJ;.. ~ , : - 1965 F'EB -3 - ~
- F'
~ ~ . . : ~ E ~'19: 48 ;
- : ~ - ~
: • ~ • = sAOGER POITRAS. ClEli~
' ' : ~ . LUCIF COUNTY. fL/RID ~ ~
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~ i FIJRTHER CHtTIFY that I will oomply wlth di olt~ nquir~r»ntt. of a lip~1 rald~nt of this St~t~. • '
• ~
:i ~ 1 FURTFiER CERTIFY that ! have no tntenllon'to rMum to my forme~ domidle, and I intend to rom~in in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permsnentty. ~
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~ 1 ~ s~~ . , ~ ~ : Lt. Coi. Bmii J wa ogei - ;
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; " ?~o~:nd wbsuibed befor• me this - 3r~, ~y ~ Februar~ 19 65 !
ROG~ rOtTRA~ .
± f ~ Nohry Publk : .
1
; ~ ~f? ~"G D.C. My Cpna~i~ion ~cpitia -
y .
~ (T~ b~ ~onew~d M d~lis~ a~ ~i~i~~l AM~I wMl~ Wrk,Cira~it CMe~ aM{ ~ilal~ wM~ Taac A~K~ _
So ~ ~I~ ~b~~ si0 ~~56~
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