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~ TO TILE STATE Ate! 001M11y411V~~~i~OR, ~ "^~ ~ ' j ~_
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- This b my dedaration'of ~~kiN and '!tis«~iap M ~tlM aAl~ O~ NNi~i ihM i Mn ANA: ~hN daft in aooo~~
- and in aonformily wNh Ch~phr 2~, seelioe x.17, i'Iot1~1. ~NhtMt:. -
1 was formerly a Ipd reaki~rN cf--~i*-__-_ ~ __----_-- ~~ . -_---=~d --------=-- ----
' - ~~ - Mewl ~-
and I nsWed at_2$2;3_$path-l~Yelter---------------------__ . ' Fbwwr, 1 haw d~ar+ped my domldle
t1M+M .wr Mgt
to and sm~and haw been a bona fide r~sideert df the StaN of [Rloride sins-------~-----------------~'1- ~
Q~~Qb_~____________________...-. 19-:b1., and 1 `node at __~..1'j1~.4asLi~ai..Gi`~•------ ---- -
- Aswt .wtl art
Fort--Pi-erca- -------• -=----_-----$i-,r~e~#e----------_ county, fiorida,
and this statement b b b. taken as my dedaration of dtf~panship, edwl beat ' residsioe and domkiN in the State
of Florida. _
tLw,t Mn MU peMwNO ~ wd w Mb d ~1y a ~wM~, « ~~r d rs~ws* a iMSO- res~it~,
wn.ovd .1 twM~r a Mw d~wkM~ ~e~diw et t~~ .teJ
B~stabliahing residency
101463 .
FRED AND R ~ORaED
~ 800K
196t JAN -2 AM 10:49 .. ••~ .... ,
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ROGER POITRAS. OR OA + .~ ;;~' ,.:~: ' ~~~~',,~
Et lUC1E CBUNtY. F~ ~`':.: ~; . _.j ~; ' : ~. ` ~+'
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i FURTHER CERTIFY that 1 will rpister at my local address when the registration books reopen, and comply vilith
sll other nquirernents of a legal resident of thb Stab.
1 FURTHER CERTIFY that I haw no Intention b nhxn to my former domkile, and I intend b amain in______
Fort Pierce _-- S~.~F19 ------____-- coumy, Florida,
permanently.
...
2a ~ ..+~ .. ~ ~.y 9 62
Sworn to and wbscribad before me this_ .. _ .. ~„r_a_ 'i ~ 1-~ ~ ---------------------, ____--
ROt~RR POITRA9 - :. , . ~~;:z• ;~ : :~° ~` _ _
--_--------- ~ --- ~ CLERK GRCUIT--- ~ ~'e"~ ~ ~~r~ s~ f ~ ~ --------~ary Publk- ---------------
8Y -----------------------------------+~ ;tS,R: ,~!_~o1j~A+i~on expires ------------- --------- ---
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R. M .....w+ ` i~b.b ..r ~ e~ .CMq, b/ ~.b aM Tas wn....d
a-oo, rt. assns -
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