HomeMy WebLinkAbout1354 'b'ora~ B. T. t:~01•D-ti0Y~i4) ~ / .
~ Declarotion of Domicile and Citizenship
TO THI~ 3TATly AND OOUNTY TA7C Q?S3~.4801i, ~
st. ~u°ie covrrr~r, Fr,oRm~: 2~Or9'2~1
TLia is my declasation a~ Do~midb and GYtisenship in th~ 3t~?te oi Florida that I san !llin~ tbis day in ~
aocordance. and in oo~tormit~? witb Cbapten ZZB, Seation 22Z.17. Florlda 3tatntes.
I Nras formerly a le~l ~wident ~18__.~ tisconein
(~4) .....~........-(8t~t~)
nnd I resided st_...._......'~1Z ~@ Street However. I have chan~ed my domicik
t8tr~t a~d Namb~r)
th~ first ~ ~
to snd am snd have been a boaa }1de resldent oi the 3tate. o~i Florida sinc~e......_---__.._....__..____.__.
January ~ 19~~ ~ I~~ ~~gt Zeavenworthf aa (IIS Arm~y temporary)
--____M_._ -
(~t~wt a~wi Noab~r) ~
I.at...fi_..B1q.~.1T04. PQrt St. Lucie ~ St. Lucie ~ ~o~,
tcxRs)
sna this stscea?ent is to t~e taken mr aeck~ration or citi:ea.hia .ct~usl le~a rs~iaa,oe .oa aomicile 3~,
the 3tate oi Flosida.
Iawrt Day W vati~nt l~tt~. a~eL ~s ~~rop~e~w ~~e.r1 i~puishs~at at a~oio~s~at ~t
a~~r doaidN. r~onMl at la~ib to arw a!
. i i}.. J. r u.. J.... j... ?1.e~ it,n; +sA Q~n~'ee A7.w~v nln ~w~'tv0 titltv_
a{~ ir~lQ ~IZB~QLIL ? Qlii ~ ~ii~Li ~iii Vit~ LiiiJ. vvss v avs vvss ssss';j '~ss ~r re :
I bt~an paying on ny lot on the lOth oi llarch 19f~ and will soon
have ~t paid o~f. I, or a~r family own no prope'rty~ at my old domicilo
and have not lived perma.nently in Wieconsin eince June oY 1961:
i~
Lu°ciE caowilr
i pOCER POtMAS
! RECORO VERIF ED ~ou~
;
; . _ ~ i3 ~o ~
~~1
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I FURTSEIt CEIiTIFY thst I will re~ister at my local addreaa w1Yen the re,~Iatration boolca reoP~,
~ and comply with aU other rsqnirea~enta of a k~sl residwt a~ tbis Stat~.
I FURTSEB CS~TIP'Y thst I hsv~ ao intentio~n to r~sture~ uw i~,.s.. a~.~~.,, ..a s~....~..-...._..:..
~------~~~t-.St~-~.~cia ~ LII e Counb?. PSarida.
~ P~~anent~?• ' ab~ 0
,
~ ' aa.) ~
~ f sre Ft. I,eavenworth, Se 66027
' ~Add~a~)
~ Sworn to and su before me tbis_,Z1aL.da~r a~
~
A. D. 19?l..
~ J.P. , , AsstAd~Gen
~ otar~? !'losids at Isrp
My? ('i0llllfl~83/01I BXp~!!~._._._._
~ T.ui.f t n{ t. • ~ ~
~
~ (To bt u~uba b aqiie~a ~wi ~1 ~Md witi t~~rk t~neok CwrR. ~si ~~lieaa witi 71as AwMOe)
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