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Declaroti~n o~ icile and Citisensh
P
TO THE STATE AND COUNTY TAIL AS8Bi3808.
8'P. I.~3I= OOUrTl'Y, IY'LOBiDA:
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This is mp decLntian u! Domidk and Citben^Lip is the State of Florrida flat I am 91ins this dap in
accordance, and in eaniormity with Chapter 2?Z, $ectbn x.17, Florida Statnta.
I was iora~lp a keel raident oL_.____ OII~IIQA'!TZ ~, OHIO---.____~
~~Z 3r.L1i.rtst:k lgutt3e iT{iii 3~i Q}~i Tiwow~~ T Lew wi.~warr~ w.v .i~tw~sw;la
- and i resided at__ ------- ----..._---------------, ~v.,~..:., ~ ~.~ ~~_,.
(8trat od Nobs)
to and am and have bees a bona llde resident o! the State o! Fbrkla since----_-- ~---------_-_..___~_day o!
_-- _ _ . 19~.., and I raids at 11&LSr.4a.ol~iel ~_~ _ _--
------w~gnat
($br.at anO iraaies)
Dort Pieros
St . Lno i e ____ _...Connty, Florida.
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and this statement is to be taken as my decLration of dtisenship, actual legal reddenoe and doaicila in
the State o! Florida.
(IANTt bail iLr pttLm~IIL facts, alfCh M M1iY~ ~O~ IOM. ~~+~11t1anWtls~t d a~>'~st at
TOT'mfT d0>'~Ca. !'~O~a~ 0~ ta>s~ t0 O~w
9~i_28'7
~~ ~~ ~~~~ n,Er "~JE~
I°5+ J'"' -9 AM 9:17
„•., ~ i:rt f'Oli RAC. fl'~};
ST. LUCIE COUNTY. FlOiciuA
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T FLTRTfTF.R (`.ERTIFY that I will retrieter at mp local address when the reeistration hooka reopen,
Aid comnl_v with all other requirements o! a legal resident o! this State.
I FURTHER CERTIFY that I have no intention to return to my former domidle, and I intend to remain
Pi ero s
Dort St .Lua ie
~-_---Cotu-ty, Florida,
_
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in._____
(its)
permanently. __r--
----___--, ---
cxa»t.I
Carl B. Stone
____________-____-___--
- ~_ ___._~~A~l
Sworn to and attb`~-~T bl1~e ~_- - 9_-_---day of .
-,
---- ~ . ~. '~s~
(TO ~ lxr00ta~ r~ a>~ ~ eta ~1< ~ ~rt+ aatl dHplititA wiL>t Tas Aswsor)
Bona aoDDl7 Ct., Plant Clt~, lla.
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