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_ Oectaration ot Do~nicile a~d Cittzenshlp ~~ss5
TO THE S~ATE AN~ COUNTY TAX ASSESSOR,
' ST. LtKIE QOUNTY, FLORICA: ~
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This is my d~da~ation of Domicile and CitiseniF?ip in th~ State of Florida that 1 a~n filinq thi: day i~ aooordano~ and . ~
i~ aonfo?rr~ity with Chap/er ?Z2, S~ctlon 222.17, Florida Statutes. ~
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I was formKly • leqal ~esid~nt of J~Cg~~ ~~+jichiQan i
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.~d t ~aW.d 81? Lincoln $treet How.ver ~ have d,.nQed rrh? ~miSile !
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b and am ~nd h~ve bsen a bona fide ~ide~t of the St~b of Florida sinoe let ~y ~ #
~ . Au~ttet 6 25 80 25th Vero Beaeh
, , 19 ,'~nd 1 reside st * '
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I'ORT ~IERCf, SAINT UlCIE COUNTY, fLOR~A
, and thts statsmsnt Is fo bs taken as my declaration of citinenship, actvel leqal ~esidenos a~d domidle in ths Statr of Fbrida.
. qn~t hsre any pertinent facts, wch as sale of proparty or business, or miinqui~me~t of empfoyms~t ~
. st former domidle, ~enwval of fsmily to new domidfa, purchase of har~s, etc.)
8htering Dennia Ruseell Wright in the 2nd gra8e
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t964 SEP - i aM 9: 04 : :
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- . ROGER POtTNAS.CIEitK ."""s:~f.•
ST. IUCIE CQUNtY. fIORIDA ~~~n ~ y+~
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i RIRTHER GERTIFY thst 1 w111 comply with all o~ roquirerr~snts of a lepai nsident of thb Stats.
~ 1 fURTHER CERTIFY that I hsvs no intention to return to my former domitila, and 1 intsnd to ramdn in FORT ~
PIERCE, SAINT LUCIE COUhITY. ~I.ORI~A, permanentty. .
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: • • ~ ~,c,.1 Delorise ;~Tright ( Mre willard )
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~ '_~f:~~ ~~~~o and wbscrib.d befor• me thb let ~y September ~ 19_.~~ .
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: . dRCU1T COURT Notary Fublk
~ ~-c~.L. ~i~e.eCcZ~~ C.C. My Conanisdon pcpir~s
; R• t~ ~c«~Nd i~ d~ea~. a«d .ri~iwal fU.d wi!!~ q«k Cl~a~it c~ow~, aad d~ whb Tax As~...e.J
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Dag~ ~J~ f~CEJU~
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