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Declaration of Domicile and Citizenship
2~~~818
Tv THF STATL ANU C'OUNTY TAX ASSI:SSOR,
St._ Lucie _ _ (•OUNTY, f=LORIDA:
~Iliis is my eleclaration of Uomicile and Citizrnship in thc State oi~ Florid~ that t am filing this day in
acc;orcl:~ncc, and in contorn~ity with Scrtion ~'?.17, Florida Statutes.
1 was formerly a Icgal resident oC L~~~~-- New YOrk--- and t
1~~~1Yi (Statei
rrsided at 12 --_-I?sLYSr__ ~~T4gt . Howcver. I have changed my domicile to
(Strect and Numbrr)
and am and have brcn a bona fdr residrnt of the State of Florida since _._~h~__ day ot
December , ~q ?2 ~ riside at __l~f~___Ii~_~_~t~Port _St. Zucie
- - - (Strert and Number)
---___-----Ft,_Pierce_--- • St._ I~ucie _ County. Florida,
ic~i. > _
:~nd this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Inse~~ here any prtti~rnt facts, zuch u~le of pte~prrty or businrss, ur relinyuishment oT rmpioyment at formrr
domicile, remo~~al of family to nrw domicile, purchasr of homr, rtc.}
Establiahing residence 2~481~3
FfLEO AND RECORDED
iT. ~UCIE COUMYI? FLA.
ROGf F ~~7tTRAS
CLfRK Cs;CU1T COURT
RFCORp vEY3FICD`~
•~r+ 3 iQ 4o AM '73
_
1 FURTHER CERTIFY [I~at ! will register ~it n~y~ local aeldress when the rcgistration books reopen, and
comply with a!I other requirements o1~ a lt,~~l msident of this $tate.
1 FURTHER CERTIFY that I h~v~ n~~ intrntion to re[urn to my fornier domicile, and 1 intend to cemain in
F#~PiPrce------ - • - ----~~.~_~1~~~_------ Cout~ty.
Florida, prrmanently. ~
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'oT~• _ Nrs. yavidJ A. Yal~e~o (Nancy G. ) ~
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^ 'y J 3 ' c- f Adilress) i
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rJl.lA•~ind~ubscribed brton m~ this 3rd ~1,ly of
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_ _anuary - f~.D. 1 73 . °
N~itary Pubiic Strte uf { lunda at L.arcc ~
My Commission expires_ Ja11u~~a~ 15 ~ 147~
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( To hr r~rcuted in Ju~Gcate arrJ ~iriFin~! i~1ad with ('lrrk ('~rcuet C'ourt. and duplicate Nith Tax Assessex)
R~ 209 ~~~;1754
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