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Deciaration of Domicile and Citizenship `
"I'U Ttit~ S7~ATl: Anl) C'OUh"I~Y "tAX ASSI'.SSOR, ijQ~.~06 '
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ST. LUGIH _ c'oUt~T1'. f~LORIUA:
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~liis is my drrlarati~~n ~~1~ Uomirilr and ('itizrnship in thr Statr ot~ Florida that 1 am ~il~ng this day tn ;
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accar~lanrc, an~l in conli~nnity with S~ction ,_'_'.17. Hlorid:~ Stat~rtrs. ~
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1 wa~ forni~rly a Irgal rrsi~irnt ot ~~_Itil4QT~_--- ~!~X~~ and 1 :
' ~(•~~y) (Statr) `
resi~trd at 3314 B_chodal~_ Ave._ Howe~~~r, I have changed my domicilr to °
(Strcrt anJ Numbrrs'!` `
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and :~m ~i~d havc br~n a bona fidc nsident af the Statr uF Hlorida since ~L~l---_---- day ot~
,j~u$.~y_-- _ . I9 48_ , ancl I residr at 11Q_ SZ8kX9Qd_~riYl-- '
(Street and Number)
Port._$t_. _ Lucid_ _ , St,__LuCid_____ _ County, Florida, ~
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and this statcmrnt is to br tak~ n as my derlaration ot~ citizenshi~, ~clual legal residence and domicile in the State
ut~ Florida.
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~Insrn hrrr am prrtinrnt farts. ~urh as vlr ~~f pruprrty or Ausinrst, ur rrlinyuuhment uf rmployment at former
dum~c~lr. remocal ut family lo nr~v d~~micilr. purchasr uf hume. rtc.l
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f1LE~ A«t t'£COitaE1
ST_ L~tC1C COuMid fLA. .
' RGCER PiiliitAS 4
Clf~?K Ct;cCi~li COifRT ~ `
RECOF~ iIEG ~1~0
i Mu~ 19 9 56 AM'75
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` 303306
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~ I FUKTHE:R CERTIFY that I will r~_~istrr at m~~ local address wi~en the rceistration books rropen, and ~
~ romply with all oth~r r~quireme»ts of I~~_al r~~ident of tliis State. ~
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~ 1 FURTNER CEKTIFY that 1 ha~~~ n~~ intrntion to rcturn to my fonncr domicilc, and 1 intcnd to remain in
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` _~'Qlc~ St. Lucie &t._ I.u~is--- ('ounty, ~
} f=lorida, prrmancntly_ ~c•"•? _ . ~ _ i
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PETfiR E. DOERING ~ '
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(Name)
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USAMC _ ST_ITEUR_BOX 48i APO NY__09710 ?
(Addrrss)
WI H TH8 U ARMEU F~RCaS ~U~Bp~, APO NY 09079
Swo n t and s sc ~d Torc me this _ _t ~fay of '
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~ k~~ry blic Slatr uf Flonda at I ar~~
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; ~ ?3: <<, . , 4°~~.~7;s .=~N~~~ go~237 P~~1564 ~
; ' ~ ; ~o ~ ~~ssion '~A;res CPT. QM -
' i•-` 1~ ~ Summa Co
_ (Tt:"lx r•cuted in Jupl~: ti• .~n q. ~+ith l'Irr1. ('ircuit ('uurt. ~nd Juphr~te acilh Tax As.ceuor)
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