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Declorotion o~Ti~ Citizenship
TO THE STATE AND COUNTY TAY ABBE88O8,
Saint Lnoi a OOUi~I'1'Y, 1RABIDA s
This is my decluwtbn of Dominus and Cit3ssaship i>! the State ai Florlaa that I am ~s thb dsy in
aocordanoe, and in conioranity with Chapter 282, Ssctiois 282.17, Florida Statutes.
I was formerly a lazg'al r~ids~+t e+i__--- QYBaahobe~~j _- - ------------- ___I ---- --- ----- (sisr~) ri~a__--
and I resided at.__-_-- BOA---- - --------~.--__------------------__-. However, I have changed my domii-ik
(BtrMR a>.d Naa~ba)
to and am and have been a bona ~iae resiaent o~ iue Stain vi ~i~i~rait- tw4ee--------------~,~ ~~±_..------_____w ui
- __~ J-~ne_~ ___~_~, 18 ~, and I reside at ~o Ind _ H~~~a D~~~e
-------- - (8tewt sad Nomber) ---
l~ort Pieroe ~ ~~~oaatya~orida,
(aa) • •
and this statement is to be taken as my declaration of dtisenahip, actual legal residence and domicile in
the state of Florida. .
tor~ domie~i. ~ cd ~ t4to > ~aom+eW,°p~+eh..: o~oae», ~ erilin°ojshm'°` a~ ~mplomMat rt
Puraha asd a new home
91_~8`~
FIlEO-•AND RECORDED
~~,~: J~11: -9 pH 9: -i8
it , ~ i_Fi POITRA~•, ", r"Y
S+. LUCIE COUNiIf, FLU~t .Q
~.°G
L•` -
J ~ ' -
T FLTRTIiER CERTIFY that I will register at mp local address when the registration books reopen,
and comply with all other requirements of a legal resident of thfa :!stale.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain
im____ l~ort__Pierce _ _ St.Lu.cie _~_~ty, glorlda.
(Clb)
permanently. ~ ______~ -
c~~Ll~L.r /~---------
-- ( aao)
_ Dort ~~hR____/c1?-~---------___-------
Sworn to and subscribed belore me this__-- --___-day o1 ,', t,~ - • '' a, j'•
__Januer~~--- ~_ A. D. 1961 •~` v.'s. - !• _
-- ------ - - - ----- -- --- 4•• - a . ~- ~~ 1 :~
--- -Notasr . - Slats o1 Florida at Lass ~ , =. c > ••.'... , .~ a . . ~ ~
My ComaisatOn ezpires~~~~~s_..19 8~ ' :'• :~ ~,:' ;~; •: • ~ A1~~~~,•-Y -.,•. `
(To bs sxsentsd in dayliab and osiSinal lflsd will (Fsrl Cllnait Cenrt, sad dl+plkats will Ta: Aswssor)
Bowen B~pC11 l'o.. Tlnnt Clt>I. ~`I~.