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De~laration ot Domicile a~d Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FIORIDA: y~
This is my declaration of Domic~le and Citizenship in the State of Flo.?ida that I am filing this day in accordance and
in conformity with Chapter 222, Section 2~2.17, Florida Statutes.
I was fnrmerly a legal resident of ~~`S~ - - ----I~~
(City) (State)
and I resided at _Gtn. Del. However I have changed my domiCile
(Street and Number)
to and am and have been a bona f+de resident of the State of Florida since ~~d day of
/~U$USt _ _ . 19-~~ , and I reside at .--lO1~I.---1~lh.--~tr
(Street and Number)
FORT PIERCE, 5AIN7 LUCIE COUNTY, FIORIDA
and this statement is to be taken as my declaration of citizenship, actual lega! residence and domicile in the 5tate of Florida.
(Insert here any pertinent facts, such as sale of property cr business, or relirquishment of employment
at former domicile, rQmoval of family io new domicile, purchase of home, etc.)
Estab~ishing residence and BNTSRING CHILDREN IN PUBLIC SCHOOZS
L I NDU1 M. LANB (13 q r s)
GERAi,D D. IANE t 8 yrs) FI~EO AND RECORDED
TERBSA S. I.AiJE (6 yrs) . ~OOK .;:.~'''"~~u+,,,;:,
C}(fteta ,•oa ~ :
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7 •'h,• ,,x,~!`
'65 I 6 ('~`~1 9 : ~3 : , ~
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:s I.UCIE CUU?:LY, i:~.~,~;~5:
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FLORiDA • L~=; ~•.....n,;:.-=
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I FURTHER CERTIFY ihat I will comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to rny former domi4ile, and 1 intend to remain in FORT
PIERC~, SAINT LUCiE COUNTY, FLORIDA, permanently.
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~riF7ii:j;: /
' ` ` •f f Name)
. :ti,i;,;:~::'~,L' " KENNBTH C
~ , . LANB
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y~••o~c+:~to and subscriaed before me this ___16th day of -AT1G[i~_____~ 19~5.
_
ROGER POITRA5 -
CIERK CIR COURT Notary Public
g ` _ D.C. My Commission expires
Y
(To bs exscvt in duplicste and ori9inal ~led with Cterlc Circuit Covrt, a~d duplicats with Tax Asses~ar.)
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