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TO THE STATE AND C~OUNTY-TAX AS3. .~ '_ -~
3t. Lnais ._ ~ ~• . -~ .~ ~ _
~T~N }~~ Fes- "- "' -"~~
Thb N my dadar of Doenidfa anal GlaoMahip le 1h. Stat of .Nortah 11th i wr- fha dhi to ooordw+a and
- M oanfarmity wNh Ch~taf ~, Sabo ~t.17,E ids: Stalulas. . ~ ~ " __
1 was formerly a Neal rMIdM+R of - ., " ~,~,.~~ ~-.~` ~,_~
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and 1 resWad at _--1Q~ - - : - ,.::. ` Ho~wwar~. i hew chanq~d my domidla
. to and am and haw bean a,bona fide nsidant of the Sgfa of `NorldR dna,_ 31set~ _ . - ~y ~
January ~ -~ 19 62 ,and 1 fati~ at ~ ~~_~.~r~
Fort Pierce 9t.Lncie
--------------- ~ ~..~._ county, Florida,
and this statement is to be taken es my deduatkan of dti~nship, aotwl Ipal raldanoa and domidl~ in tha Stata of HorWa.
iliwrt 1~..n~- P«?t~ faeMr weA w nla of •
s+~b e- bra ar nNn*e~r d woio~yawit [~ fa[Nr da[IeMR
' r.ew.l of f~Ny a a[w doddlw pwcAw sf hoew ety
Entering Peggy (cordon in the 3rd grads -~
1(1~241~ -
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1961 FEB -1 AM 9:52. .
••;' ;~;; :~~~. ROGER POITRAS.
' ` c,• -' ' c IgCIE COdNtY. f1~~0
J •,`•`t•`• /•
I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and comply with all
other requirements of s legal resident of this State.
1 FURTHER CERTIFY that 1 have no Intention M return b my former dornidla, and 1 intend to remain in
Fort Pierce -St.Lucie
---=------------------~ --------------------. --------------- ----------------- County, Florida,
permanently.
Mra 3. L.Corn°~o ~
I
Sworn to and wbscribed before me lhis__al~~_ ~_
------ ---RQICEB__1'QIT~~------ --~
R f'OITRAS, CLERK GRCUIT COURt
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ession expires .
_. ___ , 19__62
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