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- O~luatlon o! Domiall~ a~d Citiz~~sh~p
TO THE STATE AND COUNTY TAX ASSESSOR, ~
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of t)omiclie and Citizenship fn tM State of Florida that I am filirp this d~y in aaorda~+o~ and
in conformity with Chapter 2ZZ. Section 222.17. Florida Statutes.
1 was formerly a Ia9al, resident of QYj b ~
• KttY) - (Sta»)
and 1 rosidsd at A~ _ 1 . How~vu 1 haw charp~d my domWlR
(StrMt and Number)
ro and am and have been e bona fide raident of the State of Flotide :inoe 29~ d~Y ~
e»s»Q+ , 1q-6.~, end ~~id~ at 13~2 3eut~ 33rd 3treat ~
(Streef and Numbet)
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and this statement is w be taken ss my deda~ation of dtizenship, ectual Ipal residenoe and domidl~ in ths State of Horid~.
qnsan here a~y pertinent facts, such as sals of ptopKty or business, or nlinqui~merit of employrn~~t
at ~me? domidl~, rs~noval of family to n~w domicile, purchass of home, etc.)
Sperr
$ntering Henry -in 6th Grade
FILEO AND R~CORD~D
57. IUCI~ COUNTY. FI.A. ~
' ft~CeR~ V~~tIF1E0
159932
'6t SEP i I A~4 9: 43~~
, .
i- ~torr~ N c~oiTRas
CLERK CIRCUIT CQURT ~
1 RJRTHER GERTIFY that I will aomply with sli oth~r nquinnwnts of a lepal reside~t of fhis State.
1 FURTHER CERTIFY that I have rw intention to retum to my former domlCile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COtJNTY, FLORIDA, permanenNy.
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(Name)l[re. Helen 3perr
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:si ~~yj~rn to and wbsuibed befor~ me this 11th dsy of se~t~e$ . 19~iZ.
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-.'Cl~I~,C~q~,~.~p11rT -Notary Public ~
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