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and 1 resided at -_-- '~Q-~~,-~R~..~Ai~Q~~.~.'1.~..~---------~ Howes, 1 haw d>~gad rniY ~pmldia
petit and M~
b and sm and Nava bean a bona fide ntidMrf oi: thi Sfalwa of Florida sittol_.._~__.at~;;:.:~r:.~~w_---- ~- ~
------------- -BtyLOS1~? ~~ ~, 19_ ~:, and 1 ra~ida at ,~
ar..f .wd Mnwr.~
--------------- n•_Pioseo~_ ~ et.Zuoi~ Cow+h-. FloricM,
and this statemer>R h b ba taken as my dedaration of dtiaanship, ietual Ipal tesW~ttoa and domidla in the State of Florida.
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• Ow,a~r tww anlr PcrMw.nt Iacta, aud~ w gala of prapalr ar Waiww~ ar nlMquNtcwit o/ awrriapnant at tainar dwdoMa,
nrwaral ar tawiNf- b new dawkJl,, pwelwa of howl, "de.)
101555
M ECOA BOOK
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ROGER POITpAS QFRI(
iT. IUCIE CBUNTP, ~LAl11A~
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1 FURTHER CERTIFY that 1 will rplstw at my local sddress when the registration books reopen, a •'.... ;:., with all
other r uirements of a 1 ~~~•
eq sgal resident of -this Stab. ,•• . .
I FURTHER CERTIFY that I have no intention to return to my former domidle, and 1 intend to amain in
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Merl ~----------------. -------------~1R.7,ninia.----------- County, Florid.,
permanently.
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1106 Hoaoh Oourt,?t.Pioroo, 1~lorido
me this------~~~-- -----~Y ~ ---------_-+Talalllllf------------------. 19_-~--
,.. • __ OIiAZ, 7ia
',,~Lr ~ ~~ ,CLERK CIRCUIT COURT
Notary Publk
-----_-- D.C. My Commission axplres.--
(~ M .n.ecNd In dr~IMw awd alalaol tM.d ww dMk ~ ~a•a:.nd ~w ~ tan ~~aoa«I `•
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