HomeMy WebLinkAbout1906"~ X37
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D~clarot~on o~ Don~~c~le and Cit~ze~sby~. ~~~ cou~iTr. FLA.
TO TH$ BTATS AND t70UNTY PAZ A8~880~t. .
9T. LIICIE .~ID~= .
lbis is m7r dadwsstioa o[ Domidla and t,~saslkip is tbs State of l'focida that I am Hint this day in
sooo:danoe, and in ooaioeaiip with Clsapter 1~, $eetioa X9.17, Fkrlda Statatss.
I was tormeru a 1ep1 reddsnt of P8IC811AD ~ - ~ w~ VA . ._
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and I resided at_-----Rt-.--1--Boz.-AS- __._.- ._.. Ho~wwer, I bava clued aU- domicils
t8t:wt qd Zlo~b~e)
to and am and have been a bona sde residaat of the state of P'brida since______~th _--__.__~__dsy of
_ ~_~~ . 18...SQ., and I :+esjde at 410 Pala whs. _
t~>Ir•t ~a/ Nm~Nr)
-__~'• PIERCE ____$T.. LATE ~Coaaq, P7orida,
caa~
and this statement is to be taken as my declaratico os dtissoshiR actual leial rssida~os and damkils in
the State of Florida. -
t ~ d~o.iei~k r~mad~a~tlb ~~ arwdoas~s~, ~w d ~i4.?~ ~[ ~io~m~t st
i~ ' ~o : ~.
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cn cn nN(1 RECQR~~
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cc, r~ ~ 1 ~~~~ s~• Q~
I J V .
ROGER POITRAS, CLER A~'~/
S~•
I F;~ItTIiER CERTIFY that I wiL regia#~r at my 1_+acal addr.~a ~h!-n_ the rEgistration hooka reopen,
:ui~i comply ~ta~ all at~ieg c'~j'ufi~sruGuts o~ +- iB~i r-..:~t ~ this 3tat~.
I FURTHER CERTIFY that I have no intention to return to aLq former da~nicile, and I intend to remain
ia_-__~~_~~~__~-_,-_-- ST • LU~_~ _Connty, P9orlda,
permanently. (C~) ~ ~- - ~~~ / .~
Sworn to and subscribed beios+e me this__1It h ~ ~
ROG$R
(To bo auentod is dcDlie~b and orlRtnal
Cif
Bowen spDD17 Ce.. PLet pt7, Tla.
-- uTl~ tuTpYICH -
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h' 1 /' iiJ. ~ : r '
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DEP. CLERK ~',.,:_•~ ~ r. E ~_...~`=~,,.
witL Cork Ci>neok Court. asd doeikau wi~ii.'~ ~Al~r,,} ~~ ..~
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