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Dsclarotiop ,sdf ~~~a1t~l~twd Citize~>~hip
TO THE STATE AID COUNTY TAX ASSESSOR,
$t• IA101• ~~~ FLORID/1:
This is my dadaratbn of Domidle'and Citinanship in tl» Stab of Florida that 1 am filing this day in aooordanta,
and in conformity with Chapter Z4Z, SaYtion 2Y2.17, Florida Statutes.
1 was formerly a ipal resWent of_____________ ---------• -1~--------
. Sena;---- tcert-- a~la
and I resided at____~,~,$~ - ____ _____________. HpwVer, 1 tiaw char+pad my dOmlCila
~6-..f~
+'~-4#r~--------
to and am and haw been a bona fide resident of the~Stab of Florida sins---_--_-- -=---~Y ~
___________ D®aeber _________=. l9_~]r,,,, and 1 riside at _---914- ~«>~15~ _~treet.,------
-------------F~.Pi~ er---- ; -----------• ----------=---5#r~-JiuC#e-------- ~h• Florida,
'and this shtamant b to be taken as my declaratbn of citizenship, adwl Ipal residence and domidle in the State
of Florida.
tMwrl hw anp /~rNlltllt tads, weh w NM et prpM~y « rwMM. er e~YwM1 ~( NO/Mr111MM M ~flOp d~idM.
n~awai a4 1NIM1- N anw alaaai~w Paella a~f Ilaaww deJ ~ ..... ~...
Sntsring Diane hee Ooneslo in 9th Qrade ~' f _« ~' ~~~~ _
Joseph Oonaelo in 5th Grade g • :~~- ~ . , : ~.,
;,,,w~,. y' d ,~ y~M~,y
~~{~ ~ f f
~N/• .
- ~~,~~~ ~~C~~O~~R~~
~~800
K
_ 1962JAN -2 AM 10:23
. ROGER POITRAS, CLERK
ST. LUCIE COUNTY. FIORIOA J
i FuRT-fc~t ce1TlFY thN I wiq of my coal :can.. when the repbtration books reopen, and o~mply with _
all other nyulr«rwna pf • l.pd ne~deett of thb stae. ,~
1 fiURTHHt CEItTIfY that I hew no lnlenrion >n rNuM to my forms domldle, and 1 Intend b nrr+ain iti___--
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~ - ....~..r~..:~..r..~ '~.G. All1-. CQenmisrige. ~pMN ....., _r- - --. ----- _
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