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~ w ~ar 4'r.~ C!'~~ ~'i~+~:M'ti .~'L"~` '•.Q .:r . . . 7~ • 'e~a~ `•.+~~~rr wy1 ~~.1~ t~~.,~~.~.. ~ . . , ~ DMala~atb~ at Don~idl~ a~d Citizenihip . . - _ ; ~ TO 'f'!iE $'lAl"E AI~D C~OlNVT1t TAX "~R. ~ ~ ; 13433~ ; : st. u,c~ ~ou~mr. ~o~: ~ ; 7hb i~ eny d~darat~On of Doenkil~ a~d Cltl~'iship in 1F» St~~ of Horida tMt i ann fllieq fhis day In aooordano~ and ~ ' M oonformity wilh Ciap1~ 2~7, S~ctiaw+ 2'22.17, Florid~ ~t+~tutu. ~ t was Iorm~rly •!pa! rwklK+t of I~eMasl[ ~h3O . l~tY) tStsta) ~ ; ~ 963 M~lls A~eaue . HcwwK I hav~ d+arq~d my domWl~ _ ~5tr~et M~d Numhsr) _ ! ; b a?d aFtn ~nd hiv~ bMn • bona fid~ rosident of the Sh/r of Ftarida slroos 1 , day pf ` i Aam=st ~ 19 Q3 i~~ „ 313 S.13 3treet ~ (Stre~t ~nd Nven6erj i ~ ~ 1~ORT MERC~. fAM1T tt1ClE tOllNiiTY, !°LORlD/1 . ~ $ snd tha st~trrr~si~t is to bt. t~ku+ as ~rry dedaratio~n of dtixe~ship, aciv~i leqai reside~ae ar~d dort+ia'ii in ths Stat~ of Fiori~, ~ . (l~rt h~r~ a~y pertin~r:t faets, such u sale of property or b~,=ines:, a rolinquishnant af amploym~nt ~ _ ~ at fan~ domidle, rennovsl of fsmily ta new domicile, purthase of home, atc.) E t , ~~N~~N~~~.~..,~. t ~MN~~~~~ : '~~GVtT ~o~ ~ i3~33~ _ r~. ,~M ~o~•~,,~ ~ ,.;r:~ s~„ ~ n . . . . : ~ y = ~ ~ ~ ~ N CpR . + 7 t._~.~~.` ; ~ a1 _ ~~~~~~~E~ ! ~ p - : .t: r . } ~ f . . 4`r ~ ; ~:,;,tv~~ :....Ga ~ 1965 . { ~ ~ ~ z4 PM 4. 48 : ; ROGER FOiTRAS, CLERK ~ Ba#sbiiabing residance ~~$t. l~lC~E COUNTY. F~OR A r ; . • ~ 1 FtJltTHiER CERTi~If that 1 wqi comply with al) ather requinrt~a?f: of • tpal ~idtnt o¢ thi: Stat~. € ~ 1 FURTHER t~R71FY•that ! have no intentiars to retum ta my former domiCile, and I intend to ?en?ain in FORT PIERC'E, SAIIVT Lt1~lE COUNTY, FLORtdA, permanently. . ~ 3 ~ ~ ? t~ff Y1;;.~, (N~m~) p' • ~ F ~ ~ = ~ lo~d M,. Pokt 11 J : ~ •~t : ~ ~ - ~ (Addras:) •`•:::..•`,0;~~, . • . ~ i ~ •..SMrorn b an~d wb~crib~d b~fo?~ me this u dey ,~f ~~Ch i9 ss . } ROOa ~ITR/1t ' ~ Nohry RuWk ef/ D.C. MY Co~r~missbn sxptns f ~t'~ iM aarewlari b~ drrp~kaM~ ~d ~~iM~d w~ CIMl~ CkarM Cowt, ~d d~lia~ls wMh Taoe A~ra : ' B~OK , „ _ . _ . .