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D~alaration ot ~miall~ ~d Citis~nship
TO THE STATE AND COUNTY TAX ASSESSOR, • ~
51. LlIC1E GOUNTY, RORI~A: ~
, This is my dacla~stion of Oomicils and Citisenship in tM Stat~ of Florid~ that I em filinq thit day in aooordana and
in tonformlty with Chapter 2Z2. Section 222.17, Florida Statut~s. •
1 was formerly f Ipal rosident of ~~eg~- N~•rr Ynrk .
(C1h?) (St~~~
and 1 rasided at Box 91 . Howewr I haw dwrp~d my domWl~
~t and Numbtr) ~
ro and am and have bean a bons fide rosident of th~ Sts» of Horida sino~ 27th d~y of
March ~ ~q 6? ~ a~ ~ 560Q ~outh Federa~ H; ghway
~ ~t aod NumbK)
l~ORT ~ERC~, SAfNT LIlG! COUNTY. RORIDA ~ ~
and, this ststament is ro bs taken as my declaration of citizenship, actual leqal residena end domidlR in the State of Horid~. "
(Insert here any pertinent fscts, wch as sale of prop~rfy or busi~s, or rolinqui~msnt of ~mploymMt
at former domicil~, removal of family to nsw domicile, purchase of home, etc.)
Entering children in school
Penny Jo Landers in 6th grade
Pa~ela Jo Landers in 6th grade
~ILED ANO RECOR~~D
ST. LECORO ~ER F EO~~ .
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~ Z : 25 -
•sz ~ .
~ ~a~~~R~s
- ELERK CIRCUIT COUR7
i RJRTHER CHtTIFY thst 1 will aomply with all otF~er reguirernsnt= of a Ipal residsnt of this Stete.
I FURTHER CERTIFY thst 1 have no intention to retum to my former domiGle, and I intend to remain i~ FORT
PI~, SAINT LU~IE COUNTI(, FLORiDA, permanently.
a or J. Landers
(Address) •
S~worn ro ara¢:s~ibsaibsd r e me ~is 3 rd day A~=i 1 , 19~.
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