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Declaration ot Domiclle and Citisenship ;
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TO THE STATE AND COUNTY TAX ASSESSOR. 153~38 ~
Si. LU~IE COUNTY, FIORIDA: t
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This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this dsy in acoordance a~d `
in confo~mity with Chapter 222, Section 222.17, Florida Statutes.
Rutherfordton North Larol;na
1 was fo~merly a legal resident of
(City) (StaM)
Route 2 BOx 238 ~Wever 1 have changed my domitjle
and 1 resided at -
(Straet and Number)
ro and am and have been a bona fide ~esident of the State of Florida since 21 day of
_Tanuar~r , 19 6.7, and I reside at p•~•Box 3672, Route 1
(Street and Number)
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FORT PIERCE, SAINT LUtIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, act~al legal re:iderKe end domicile in the Stete of Horids.
(Insert here any pe~tinent facts, such as :ale of property or busineu, or relinqui:hment of employment
at former domicile, removal of family to new domitile, purchase of home, etc.)
Establishing residence
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STR
UC E COVpC~.~
ECORD y~R~~~E~..
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'6T FEB 2 7 pa 2, e i
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IERK CIRCUIT COURT
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I FURTHER CERTIFY that I will oomply with all othe~ requiremenh of a leyal resident of this State.
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I Hl~~f~.~ ''E~,TIFY that I_ have no intention to retum to my former domivle, and I intend to remain in FORT
.y,,:;_;.tiJ.
PIERCE, SAII!~' ~CIE'~JNTY~f1:~RIDA, permanently.
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1' tY s " ,4 ~r~° s . (Name)
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, ::`,j, .3~ Lawrence E. Stanger
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• (Address) ~
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27 Februar~r 67 ~
Sworn to and suburibed before me this day of . 19 • ;
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Roct~ romtas ~
CI UIT COURT Notary Public
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gy D.C. My Commission expires
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(To b~ ~x~cvhd in dupliuh aed oripinaf ~il~d with GKk Cinvit Cou , an u liut~ vrit Tax A~ssor.) ~
~ooK164 ~~E2373 ~
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