HomeMy WebLinkAbout0947 / ~
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STATE OF fLOAIDq) ~ ~ ~ ~S6'7U
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COUNTY OF ST . LUCIE ~ ~
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TNia !s my p~cl~n~on of pomidl~ Ir~ ths 8tit~ ot Florids tP?at I am tilinq this day in accardance ~
and in conto~+iN wfth S~Cllo~ 22217. Florfd~ Statutea.
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~ tWe~ W I L u ~ R 1_. 1~~'.f'1 ~ L F , 4
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bscame e bona 1id~ nsfd~ni oP ini Staia~ v~ Fi~~ ____,i..°- ~ ~ q
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and 1 roside at ~ ~ =-9.c ~._.U--~-=
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M the C1ty of-- ~~1 . ~
My mailing addross Ix ,
t~r ou~sFa~+T cnow an+~es ~coaESS?
. My formsr Isp~i rssld~ncs waa in the City ot
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.~8t8 Of vl ? i ~c w~[~C /
(No further atatement b ~puirsd. Nowevsr~ H you w1ah, you may insert any peHinent tacta
such as sals of property or busit~ss or relinquishment of employment af fonner domictte. removat
of tsmily to ~ew domic~ls. purohass d homs, eta) ~
i FURTHER CERTiFY 1 witl compiy with eil requirements ot a te9at residont ot thia Stata 1
understand tt~ro ts 0 penalty for pe~Jury; pe~ury ia e Felony and is punisheble by Incaration in the
State Departmsnt of Correctfora.
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PRINT NAME SIGNATURE
PRINT NAME SIGNATURE
Tf~IS SPACE F4R RECORDING INFORMATION
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9iwotn to ~nd N~becrib~d bNo~+~ ~ tt~ ~dh?
o~ , 19' ~s '85 ~C 23 A 9~09
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..~,:s.~'l. FIL ~
ROGER P IRQ:IT CT. ROG~~~.
ST. tUC:
By
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y Clerk '7.~$6'~Q
~F ~'~f ~RUS~.. '
cOUhT y. f LQA~n~
Notary Public~ State of.
My Coamaission ~xaires : ~;R M '
F~~ ~ BQ~K 486 Pa~E y4 r ;
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