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Declaratlon ot Do~icile and Cttt:enship
TO THE STATE AND GOUNTY T/lX ASSESSOR, ,1~3~~6
Sl. UJCIE tOIINTY, FLORIDA: ~ ~
This is my dec~aration of Dom+cile ans~ Citizsnship in the State of Florid~ that 1 am filinq thit day in ~ooordanos and ~
in oonformity with Chapter 22?. Ssction 22?.17, Florida Statutes. ~
1 was formerly a le~al resids~t of New @aStle Ind.
(City) (St~te) :
and 1 rosided at 1003 Cherry Stxeet - ~ }~W~ ~~~e cfianQed my domidle
(Street and Numbe~)
to and am and hsve been a bons fid~ residsnt of the State of Florida sinos lst day of t
i
April 19 -64 and I reside at 302 Noxth 28th street ~
(Straef and Number) ~
fORT MERCE, SAINT WCIE COUNTY, ~LORIDA
and this staten~snt ia to be taken ss my dsclaration of citizenship, actual legal ~esidenos and domidle i~ ths State of Florida.
pnse~t here a~y perlinent facts, such as sale of property or business, or mlinquishment of emptoymsnt
st former domidis, romoval of family ro new domicile, purchase of home, etc.)
1
Applying for homestead '
i33i~?6
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f11.E0 A~}D RECORDED - ~
IIV • _ - _ `
80~K ~ - - . . f
, \ t
1965 fE6 -g PM 3: 20 ~ ~ ' = ~ ~ ~
,
RO~ER POITRAS. CtERK ' ~a _ ~ ' ~s,
ST. LIICIE CQIINTY. fliRIOA ; • - ~ . _ -
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1 FURTHER CERTIFY that I will compiy with all other requirertwnta af a(pal residsnt of thb St~te.
1 fURTHER CERTIFY that 1_have no lntention to return to my former domic~le, end 1 intend to remain in FORT ;
F
PIERCE, SAINT LUCIE COUNTY, fLORIDA, permanently. - i
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c . ~ GitntG~'C' ~ .~Z
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~ ' Kenneth~ York
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, t , + • / (Addnss).
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` S~worn
b-snd wbsuibed before me this - 5
th day of Fa bru a~Y , 19 6 s.
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ROO~ ~ORRAf .
: CIRCWT _ - Notary Publk
i I?.t.?+C.~... • .
t o.c. nny c«~,~,~u~+
; tre b. ~aM~d iw dupik.l._ .na oei~al ril~d witl~ a.~lc eMa~h Cow+, .ad drpik.~. wMh Tax Aw...e~a .
~ R~~~ ~l0 ~A~E304 .
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