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~e6~aration ot Det~ic~t~ and Cttlste~~h~~
. TO tHE STAT~ AND COUNTY TAX ASSES50R, , ~~~0~,~
' ST. lUCIE COllNTY, FLORIDA: ~
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This ts my decloratfon of Qomicil@ and Cftlzenship in the State of Flari ~ that I am filing this day in actordante and
in conformiry with Chapter 222, Section 222,17, Ftorida Statutas. ~
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I was formerty a tegat rasident•of Lexin~tan ~Centucky
, ~ (City) (State)
and ! rastded at ~~4 woodward Lane
. However 1 have changed my domic.lte
(Street and Number) , -
ro and am and have been a bona fide ~esldent of the State of Florida sinca 2~~d day oi -
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_ _I~[Qv~ , 19 64, and 1 ~eside at Rt _4 Box 3? Hawley rd
(Street snd Numbar)
E:
fORT MERCE, SAINT LUClE COUNTY, FLORI~DA ~ f~ '
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and this statemant is to be taken as my declaration of cittzenship, actual legai reside~ce and domicile in the Sfata ef Horida. I. r
.
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(Insert here any pertinent facis, such as sale of property or businesa, or re(in~uiahmant of emptaymant
at former domlcile, removal of family to new domicite, purchasa of homa, etc,)
Bntering n~~ce in t he 9th grade
. Wi11 apply gor homtstaad atter the first of the year . ~
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: Fl1ED AND RECOf~D~D ~ ~ . - ',~~+z r . .
!N ~ ~ -~'~cor~--BQOK . . f'~''~°••.~."'"'`~'. .
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. . 1964 NOV • ~ , _ ; ~ • ~ ~r,..•.
27 . .
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. . PM 1. I 9 - . .
~ . ` : ? ~ 's' -~1~'r~ ~ '
. . . . ~ V ~ • . ~ ~
I ROG~R f'OITRAS, CtER1S . - - • ~ .
I , ~ ST. l r ~ .
UCIE COUNTY, f IORIDA <<
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1 FURTlfER CEitT1FY that 1 will oompiy wtth ali nther requiromenri of a I~gal resldsnt of thi: State.
~ I FURTHER CERTIFY that t have no intent(on to raturn to my formar ~domir~te, and i intend to remait~ t~ FORT
~ PIERCE, SAINT LUCIE COUNTY, FIORiDA, permanentty. . -
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~ - • ~ tName) .
^ :z: ~ rt • Mrs. Ja~es ~ Crough
~ ' • ' ~ ( foxmerly Florence J2fnes )
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~ ` (Addrai9) . -
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~ ~,~lA~..~~r 2?th ~ November 4
~ ''~'~tMbm to and :ubscrfbed before mte thi: day of , 19
s ~ ~ _
3 •
~ ROGER POITRAS
' ' CIRCUI COURT ~ Notary Public
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_ '~'`"'~'`'Q' Q.C. My Commissbn expires ~
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~ ~ - ~ ~ - 84~K ~l)4 FA~E ~ E~~ ~ ,
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- Ro b~ ~x+euhd in dupii~ah and ori~inat A1~d wlta Cl~rk C~rcvM Cawrl, ae~ dvpiical~ with Tax ~or.) -