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~ - . ~ - - . ' i , ~ D~ala~~tlo~ O~f DOn'tlall~ at~d Citis~shlp ; . f / t TO T1lE STATE I1N~ ~OUMTY TAX ~SSESSOR. - ST. lt~C1E OO~N~TY. fLOR10A: This is my d~daration of Oomidl~ and CMi~ahip in th~ St~N o# Flaida that 1 am fiUnq thb ~I tn aoootd~no~ a~d i~ ca+formity with dwpt~r Z2Z. S~ction 2~2.17, Horida StatuN~. ' ~ 1 wa Fon+~ly a Ipa{ n~id~r?t of ~on ~io KKth~ ~ ~ n 4465 De~frow Road f _-3to~ _ ~ ~w ~ ~ ~w . . ~ (StrNt aed t~r+bK) - ~ ~ ~ b and am aed haw bNn • bon~ Nd~ hsid~m af th~ Stat~ of Horida dna . diY of ! ~d~JU~t.c~ , ~9~3 «~d ~ ~td. « ~ 3 ~ 5 3~ ~ - ~ (5tnat and Nu~~ ` ~ ~ ~ ; ' lO~T !~C'~. fA1Ni LtKlt GOtIlITY, liiORlpA ? ~ and thb staf~rrwnt b b b~ tak~n u my dsdar~tion of dti~euhip, ad~+al {pal n~id~+a aid dantdl~ in 11» ShN of Horid~. ~ .-(Iraut h~n sriy pKtitNM fsch, wch as ~al~ of prop~rty or bu~in~a, or nitoqui:linwnt of ~mploym~t ' ~ at ~mK domidl~, nmovai of family to n~w dankil~, purd~ af fwn~, M+c.I i . j ~ ' . . _ Setabliehing reeidenoy . ~ ~ ~ . ~ ~t E ~ . ~ . ~ 8~C , - ~ ~ 1961~ f~@ 28 AM 11: 32 ' ~ ROGER POITRAS. C1ERK ' =1. tIClE C1dNtr, fLIRI1A . I : - . . . ~ - , . , _ •o~t3~~. . 1 . _ S ~ ~ . ; ~ ' ~ , . - • ~ r.- ~r: ;s ;'t ' ~ - ~ i ~ . ' ~ ~s M 11~?s. t i;~i•~ ..r . ' 1 r•, s~~% t; n'~ ~ r ~ ; ~ RJRTHER C~TIFY th~t ~ WI~~ ~ ali othK nquirwn~nh of a leqal nsid~m of this Stst~. ~ I e~~~- 1 RJRTHER CERTIFY tfi~t I heve no int~ntbn b ntum to my forrr~ danidle, and 1 iM~nd ~in in fOitT PIERC~, SIUNT tUCIE COUNTY, FLQRIDA, permansntly. ~ _ ~ pdar+~) 1 St~phen 9~st~ tLSr . (A~d~ ~ ~ F ` ~w~orn a .nd wb.c~.d ~ 28 ~ ~ Fsbruar~ - 19 64 ; ` . i: ~ ~~te~t ~ 1~s ` ; w00~ ~OiTRA: ~ . ~ ` ; ~ . G011RT s • - ° _ Notary Publk = . ~ ~ ~ i i~~ ~ e ? ~ ' ` ~h? Ca"~N.'°" _ . . ~ ; , • e _ ~ ~ { Ri M~oaa~d i~ ~ a~ MyM~i iM~i ~rMM ~k Cfr~rM Gw~. Mi ~ wNr Tis Aw~w~J ~ ' ~ ?