HomeMy WebLinkAbout2921 Q~claration of C~orn~c~~e anei ~it~z~.n~~~~
'I'O 'i'l ll: S'I~ATI: ANU ('OUNTI' '1 AX ASSL:SSUK, 3t)(1446
- ST. LUCIE . - CUUN"1'Y, FLOitll)A:
TI~i1 is my dcrlar:ition of I)o~nicik and Citircnship in lhr Statc c~f florida th:it l ant filin~ this day in
acroniaiicr, anci in coniormity ~viti~ ~cct~on i i, riona.i ~ta[utcs. -
1~vas fornirrly a lcgal r~~idrni of Ve j le Dentna~rk ' and 1
ci~r) (Stacrj
-3Tcovmol leve j 24 - 7100 Ve j~e
residrd at ' tlo~vevcr, 1 havr. cl~anocd my domicilc to
(Strcct and Numbcr)
ancl an~ and havc bccn a bona tidc rosiclcnt of thc Statc of I~lorida since _Stih day af
December 74 2611 Oleander Avenwe '
- , 19~______, and I residc at - - ,
Fort Pierce tStreel and l~unilxr)
_ _ _St. Lucie County, Florida,
(ctiir) .
and thii stalcmcnt is to bc t.~kcn as my~ dcrlar~~tiun oC citiz~nship, actual lcgal residenc~ and domiciic in the State
uf l~lorida.
(Insrt: hcrr any prrtinrnl facts, auch as vlr uf ~ru~xrty nr buxina~s, or rcli~tyuishment of employnirni al formrr
domicilr, remu~al of family tn ne.v domicilr, purchasr of hume, etc.)
Er~`['CRI~~2G C~iILDRE?1 IIJ SCHOOL: ~i0?~STL'~1~ EXL2•iFT7U?~i: ~
If ei~tering children in school, ~ _
please list their nanes:
i
I intend to make my home here peimanently ~
~ fILED AND REGORD S~
. az. ~.uc1E COUNTY F~R.
~ ~ ROGER P4iTRAS
i ClERK C~~CtliT COt!!l1.,~\
i itfCOR4 VERtF~EO.~,~.....,.
~ .t~ t9 5 oi PM'~S
E .
E
I
' 30t?446
~ _
I FURTIIER CERTIFY that i wiii rc~istcr at my local address ~~~hrn thc rc~isiration books reo~~cn, and
~ com{~ly ~~•iti*. al) otl~er rec~!iire~nents of a Iegal residcnt of this Staie.
1 1~URTIII:R CERTIFY that I ha~~. no intention t~ return to my formcr domi~-ilc, and 1 intend to remain in
~ Fort Pierce ST. LUCIF
` - - - Cowlty,
~ )~lo:ida. pcrn~anc~~tly. ~c~"'~ -
~ ,
~ ,
~ ;~~~~~~~n~~~ ~r/I/L.J _ ` ./~.'y
~ f~~c~~t'1/T~ t_
~ ~ • \ ` ~ jE+•~`~ - - - - ~~:V~R~
~ ~
~ f~~ Jen,~ Sorensen
~ ' . •~c; r~ ~
~ =
~ ~ r'Ja``. ~ ' `i~`~' ~ ' - -
~ • ` r _
~ SIGiVl+I'LiRi':
. •
~ ~ : : ~ , : ~ .
~ . ,
S~~r~'~~nd,s~ ia~¢d bctor~ m~ this __29__ da~~ of
~ ~ : 'x~: ~-4 ~
~ TJ 2611 Oleander Avenue
~ - --~-~~s~~w"~°;
~ A.D. 19__~~___.
~ r~ i__a_ng r. ~re~s
~ RO(:LP. F~7`~RAS, CLi~R CTI;iUIT C(?UKT Fort Pierce ~~lor:.da
~
~
~ 13y De~~u~y Cleri% ,
:l Tc? be tu1rJ in dupfic:~le and crriFiu:J f~led ~~i1h !'1. .r. uit l'nurt. encl dupli~•ale whlh Taa Assessor)
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~ ~oK235 ~E2920
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