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D~ta~ation ot Domiail~ a~d Citi=~nship
TO THE STATE AND GOUNTY TAX ASSESSOR.
Sl. U1CIE GOUNTY. FIORIDA:
This i: my declaration of Domicile and Citirsnship in the State of Florida that 1 am filinq this day in sooorda~a and
in oonformiy with Chapter ~24. Sectio~ 222.17, Florieia Statutes.
~ w.: former~y a ~ege~ restdent of BrooYl~n 8ew 7ork
- (City) (Stab)
and 1 rosidsd at 3085 8maona Avenue ~~K i~~
(Street and Number)
ro and am end have been a bona fids r~ident of t~e State of Fiorida sinoe NOOeaber 7 ~y ~
, 19 68 , and 1 rosids at ~08 Bluefieh Court _
(Straet and Number)
lORT M~, iA1NT LtlCIE COUNTY, I~LORIDA
and this :tatemsnt is ro be taken as my declaration of citinenship, actvat ~legal residenos and domicile in the State of Horids.
qnse~t here any pertinent facts, such as sale of propsrty or business, or rolinquishme~+t of empioyment
st formsr domkile, rerrMVal of family to new domicile, purchase of twme, etc.)
Sntering children in public echool
Harry and Albart Qnatraro
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1 FtJRTHER CfRTIFY that I w111 aompiy with all ~ requir~nsnfs of a lepal r~ider~t of this State.
I FURTHER CERTIFY that 1 have no intention to retum to my former domiGle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTIf, FLORIDA, permsnently.
~
Ann natrero
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; Swor~`to ae~d wbsrribsd b~for~ m~ this 15th ~y ~ l~O~embar - - 19 68
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ROOlR ~OITRA:
; CLMK CtC1MT COIJRT Notary Publk
~ O.C. My Gommisslo~+ expir~s
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