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~ V iii**~~~~ ~ WW~~4 ~ ill: !A~ ~ s ; ~ ~-
Tbia is ~w- deelaertioe et D~amieiM ~emd Ip is ~e~ 8hb as ~'lo:ieTa- that I ear flWyt this ~ in
aocosdana. sad is oootoeanits with Cbaptar 8lt, $sstioa 8i<9.17. !'lorjda Bt~tgtss,
I was lasma)ty a Igpl rssideat ai .~~'~' ~T ~ ~Q~~__
._ ~d4) (ithhM)
arcl I *~+si~d at_--- _-- ~~_ O~t>~h ~s__.,_...~...._.__~._,~___.__.~... Hc~!rrter. I kava ~aa.~ mT d~idk
i~ a~i esrs)
to and sm and have bean a bona ti~ls raddsnt of the. 9tsb of 1Rotids sines._~_~~___________---_-------day ai
----Zn~~------ -----. 19 ~. sad I rssida a~- 140 >i~~ ~1th 8fr.
- t6e~ tuts ~natlve)
Pmt ~ ~rc• .---. ...3•>r~i~ -.--Coua><i-. Florida,
and this. statement is to be taken as my dealsratiou ai dtbeasbip, aelnal legal residence sad doo~icik in
the State of Florida. .
((Luau ~ w v ids. wei a..al~ .[ os bovieov„ os ~t c[ w~l.yaNSt at
fors.: doaie~. ra+w-a1 a[ t..gs to new ~ ~ yea~~ ea.)
91111
FILED ND RECOR
irl .___ ooK
IS6 JAN -3 QM I I: 30
hJGER p01TiiAS, CI~~:K
Si. LUCIE COUNYT, FLOn~~A
:: ~t ~. ... - - -
;Ti~
I FURTHER GERTIFY that I wfll register at my local address when the registratiop hooka reo~n_;
and comply with aU other requiremeata of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my formes domicile. sad I intend to remsin
~ Dort Piero. ~, st. Lna s. _~ty, I+7orida,
(C,~-)
. cria..)
~1D.rt t. s.llxoos
Sworn tQ~:~. baZoe+e me thia_~.~day of
Jalt ~ ' ~~~'. ;- 61
,.. D. !9
^i . '
(7ti by iii b doaliaab a~ a~i~rd Uvd wlti CMc,# peeait Geef, d w!~~ Y1a: Avewvt)
Bew.. eovDtr C.•. mat C1h. 11a.