HomeMy WebLinkAbout0001 y D~claration at Domicile a~d Citi~
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f0 THE STATE AA?D COIt:VTY'r.4~( ASSESSOR,
Si. IUCIE COUNTY, Fi.ORIDA: ' , •
This is n~y declaration of Oorniu!e and Citizenship i~ the State of Flotida th
in co~formity with Chapter 222, Sect ~on 222.17, Florida Statutes.
Douglas
1 v~eas formerly a legal rasident of
. ~ (City)
and 1 resided at _ 1640 17th ~r ive ~ _ _ _ _
(Streei and Numbe~)
to and am and have bee~ a bona fide resident of the State of Florida since
October 66 Sail
_ 19 and 1 reside at
FQRT PIERCE, SAIN~ tUC1E COUNIY, RORIDA
and this stalement is.to be taken as my declaration of ci!izenship, actval legal resi
(Insert here any pertinent fads, such as sale of property or business, or
,
at former domicile, remova~ of family to new domicile, purchase of hc
' - Enter ing John Jay Myhre in 6th Grade
F1LED AND RECOROED
ST. LUCIE o vERIF EO~~
Rc COP. GHV~ -
. 35
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- ~~y~o~R~s
:i0c._~'
~ CIERK CIRCUIT COURT
- i FURfHER CERTIFY thbt I will comply with all other requi~ments of ~
I FURTHER CERTIFY that 1 have no intention to return to :~~y former c
QIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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• , - - . . • : Mrs,
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~''Swo7A.tw,~tid subscribed before me this 31 day of
- Rat'sER POITRAS
K CI IT COURT _
By _ D.C. My Commis~
(To be ~xeculed in eiupliwte sr~d ori~ina! ~ilsd witb Ck~lc Grcuit Court
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