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TO THE STATE AN~ COUNTY TI1X ~SSESSOR,
Sl. lUC1E COUNTY. RORIDA:
This is my d~cla~ition of Domkile ~nd Citi~ship in th~ Sta» of Horida that 1 am flli~q thia day in aooordana ~nd
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i was ~o~.~iy a ~pa~ ~.s~d.nt o~. ~'airbanks Alatilca
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:~d ~ ~id.d at Haneen Road f ~ .
(StrNt and Numb~)
ro and am and haw b..n a bona ftde ns~ of ~1?. st•a of Hor~da stna Ae~esber 25 day of
_ ~9..~.~_, and 1 nsWW~ at 2120 Tu~er Roed _
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(;Slrs~t and NurnbK)
POlT lMRCR S~AMrT LtK1E COUNTY. RORipA
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and this stat~~snt is to be takan as my dsdaration of dti~sn:hip, actusl lepal r~idenoe and domldl~ in ihs Stat~ of Flotfd~.
. praKt hen any pertinent facn, such as ss{e of.property a buainess, or rolinquislurwnt of ~n+plo~rm~nt .
at forrr~ domkik, rsn+oval of family to new domkile, purduse of Fwn~e, t~t.)
Filing t'or homeetead ezemption and ~ ~
~ becoming a peraanent raeident oi Florida.
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i FURTHER tHtTIFY tlwt 1 will aomply with all att~ roq+ri~rNnts af a lepal raident of th~ Stst~.
i HJRTHEtt CERTIFY that I have no intention ~o rolum to my former domiGle, and I intsnd to remain in FORT
PIERCE. SNINT LUCIE .EOIJNTY. FLORIDA, permane~tly. ~
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SN„or~Y~t;;+±d u,bsa;bsd bsfore me d,is 3rd ~y ~ JanuarJ , 19~.
ROOH rORRAf
CL~RK CIRqNT CO11RT Notsry Pubik
gy ~ D.C. My Commis~ion ~xpi~
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R~ b~ ~aiNd i~ drpNeaN aNi ~ef~inr fiMd wMM Ct«k CirwN cow~, aud duplia» wi* Taoc I1~rJ
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