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Tl~ fa m, dloL~afdwl ~ ~ ~ ~ fL! 84te 0~ ~loRids tbat_,I am flliu~ this dq fn
a000~aD0e~ and i~ ~!elatllt, w~tZt L~ISpta ~ .!>l~.1?. FiOdds StstBtOr. .
I was locasullr a IesaJ redden! c! .Filtat~illa ~ ' z~yL~
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snd I resided at____-_~ ~..~~5...-~.-~.. ~ .~._..~__~_.4~---_.. Iiownsr, ~i i~sti ci,~.~ a~`- ciom~
(sir.. ear xssuNe)
to and am and haw bey a boos fide resident o! tb~ State esy I+~osids sinx.._..___l~-_._.________w_dsy a!
-------~~sr ,... ,.i; 1~_~ and I sesids __.-_----
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______ lit' ~!!!'O~ y ~i I~Qiy ~ ~QOIiII ,~. ~idt,
(Cliff)
and-this statement is to be taken as my decise+sYao c! dtiaaship. actual lesal :esideoes and doadicile in
the State o! Florida.
!o air do~~ieilw rsd ~ to ~ do~rfew. w ~[ ~i1a~ d ~
~ppl~ing for koaestead
9111'7
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f1lED At~O RECDROED
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[;+'~GER pOITRp.~. °'~r'~
I ~FURTl3ER CERTIFY that I will re~Ltat at my local address when the reslstratlan books reopen,
an.~ ~mnl_y with all other requiren~te of • l~ai retid~t a~ this State.
I FURfiHER CERTIFY that Z have no intention to return to aq forme: doo-idle. and I intend to remain
~__ Dort Pierce __ _St. I.aoi• ~~,~,, g~~,,
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pennsneartiy. .
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Donald P. ~oeasker
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3:sorn to sad subscribed bdaea me this_.~__~dw o[ -~U~ c,, ~ ~yt' ~ ~
_ Janus r7 A. D. 1~. ~~ r ~' ~ .
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Boger Poitras, Clerk of0irauit Court • "
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