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TO THE STATE /!Np CQVNTY T/1>< 1pR.' -
S t - ¢111. C~OtN~iTY, l'r~RIQ~-s~ +^ .. _ _ ~ ~ ~ ~ - i,
TMs h my dadardion of OaNdra and Gtisanaltlp in t~ EIaN of .Ertirida 1hM t adi .filln~ thh day to aooad~rtoa;
and M coniorriity wMh. Chapter ~Yl, 3~ctia+ ~l:17, -rorida iNtu1M. . ~, _ • .
1 was fonnarlY a ~ resident of____=~.Mt3r21u~^---_.__-- --.~~ __, ~__S}.40T.~~.____.,__
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and 1 rasWad.at____4Q?_BAA4_P~BDIL.--- ---------------------: I~ioMnrwr. r haw dw+gad my domldla
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b and am and Mw bean • bona fide nsidant~of the SIaN of Florida sinoa____~-lib.------------------daY of
---~36eev~-------------------.196,1_-, and 1 rrsida a1 _22a5-~~`?~-~~----------
• 3 ' tlaerM d Iiai~ef
- _______, . ____ ~+~3~it,.~! 7~:_ Ia~lg1~ ______ County, Florida.
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and thb statement is b ba taken a my dadaratbn of dtinsnsMp, actwl lapel niidanoa and domki~i in the Sta»
of Florida. - -
(Moen Mn M'!- MrMn~k beK, wcA w aM d pe~ey- or i~~ a n~blr~k of ~~k ~ boon iwNMc.
rwvel e! tee N ee+w alowlerei, pwdne~ of hews, wy
Bnterilag Alice Marie Beelaoan in the 3rd Grade of Public
School. ~~:,~ ;~~,;,
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AP~ RECO . ~ . ° ,.. ° -
M ~oid.9
1962 JIW -2 AM 9: OS
tT~IUCIE COUTRY Flo IOA
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1 FURTHER CERTIFY that I will re~bter at my tool address when the rptstration books reopen, and comply with
all other nquirerranri of a Ipal resident of thb Stab.
I FURTHER CERTIFY that 1 haw no intention b return b my former domkila, and 1 Inland b amain in______
-------------Fx.._PS.etce_---------------- - -------_~~~-~~4 ----------- County, Fbrida,
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•~•~.`,~"•~ ~3%' * ~~'' Mre. Qeorg 'ward Becl~n
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~ ~' 62
"~*''~~ a~~scribed before nfe this, ~~_----- d+y ~ ------d~A{I~~C----------------• 19- ---
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POITRAS, CLERK CIRCUIT COURT ------ Not Pvblk
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Ro M e+esawe/ V ~e ar a*I~Yr /i/ allh Clok Cher 4w4 r re~MeeM ~rM Tau ~eeeeeM
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