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Thh h my daduatbn of Domidlt and Cllt~eanship M tht SfaN of Noridn ttwt 1 atn filing thh dhr M aooadanoa and
in oonformily with Chapter 42Z, Seetbn ~Zaf, fiorida SM1V~
~~~ ~ Florida
1 was formerly a lepd resident of~_ ____ ~ __ taM . ~....-_-~____-, ----~- ~ -----
and 1 resided at _____113Z__~~_l]~Lh..,g~4~tL.----------------! However, I haw d+cnged ~ romldl.
to and am and haw been a bona fide resident of the State of Honda sinoa___.._.--...6L~-.----------------- ~Y °'f
-------------~8h._------- 19~..nd 1 reside at --Z~_~~.?cQ Court w~
F.L.P.iet'-ae---------- --- -- 9 -~ Coumy. Honda.
end this statement is to be taken as my deduction of dNrenship, adwl legal restdenos and domkile in the State of Honda.
pnaaA tnra any pwiMnns fans. suds as nla d proPa~K x hus6naM °f -~~'~ d "'~ ~ to+wnr rawdcM~,
r«naral d fadiy to waw doiatcNar owebaw d tawiw NeJ .
Batabliahing ret~.dencF
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1 FURTHER CERTIFY that I will register at my local addross when the registration books reopen, and comply with all
other requirements of a legal resident of this State.
I FURTHER CERTIFY that i have no intentbn to return b my former domkile, and 1 intend to remain in
------- ---F-orb-sierra--
tckyi
Permanently.
Sworn to and subsuibed before me this
-----------• ----------- ~.,LyLCli------ County, Florida,
Jack Stanley t:e
. .r va T r ~ ~ ~ ~ ~ -------------- ~~ ----~--~--------------
_$.~~~~°r.,:~c+b~~ ~~.. --------Jai'-"-~-`~----- ~----. i9---62-
POITRAS, RK CIRCUIT COURT ~~ ~' u : ~, •~`( ~[~lv'~ ~~~ rotary Pubik .
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try M wawM/ t. ~aealr aa/ wel~Iwd.1~I~M,..w_, ~~IpMs~~h~~ , ~~ vM taw Aassaslri-
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