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~ Oeclar~ation ot Qomi~it~ and Citi=~nship #
;
TO TH@ STATE AN~ COUNTY TAX ASSESSOR.
ST. lUC1E COUNTY, FIORlOA:
This is my d~duation of Comicil~ a~d Gtibn~hip i~ th~ Stat~ of Florkla that 1 am filitq this day M~ooondana and
i~ conformity with Chapt~r 224, S~ttioe? ~~Z.17, Hotida Statuta.
i was formstly a ipal t~sid~r~t of ~otQ! OL~O
. (ab) {~at~
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u,d ~~ided ar 8634 11~ntor Aie.- - ~vK ~ haw d~p~d ~ny don,kiM ;
(SNeet and Nwnber)
ro a~d am and haw baen a bona fid~ rosid~nt af th~ Stat~ of Florida sino~ ~ 1Sth diy of
Noveober _ ~9 68 Hoa 44a Rt 1 No Ped. Hi~ra~ -
(Stn~t and NumbK)
FORT PIERC~, SAIN? LUCIE COUNIY, RORIDA
and this :tatsmsnt is to be take~ as my dedantion of citine~hip, actual ipal r~sid~na and domidl~ in th~ Stats of Hotid~.
qr~sert hsre any pe~tinent facb. such as ssle of property or busir~ess, or tslinqui~nt of ~nipla'f~m~t .
at former domWl~, nmoval of fa~nily to n~w domicil~, pwchas~ of ho~rN, a1~ca
~
Bstsblisbiog reaidence and applying for ho~estesd
. . .
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FIIED AND RECOR~KD~.
gT• LECORD VER F ED~~
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'69 MRR 24 PM i: 2~ . .
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i RO:,~ R i 0lTRAS
~ CI.ERK CIRCUIT COURT: . .
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1 FURTHER GHtTIFY that 1 wiil oomply with all ozt~ nquirem~nts of a Ipal tesid~nt of thts Stata.
1 FURTHER CERTIFY that 1 have no intention to nfum b my formet domicil~, ~a~d I intand ~o nm~in in FORT
PIERCE, SAINT LUCIE GOUNTY, FIORiDq, pwmaMntly. ,
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ROGER ~OITRAS
GRGiiT COIJ~T No~taty PuWk
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