HomeMy WebLinkAbout0001 Declaration ot Domi~ile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
51. lUC1E COUNTY, FLORIDA:
This is my declaration of Oomicile and Citi=enship in the State of Florida that I am filing this day i~ atmrdance and
in conformity ~with Chapter 222, Section 222.17, Florida Statutes.
Cleveland Ohio ~
I was formerly a legal resident of _ _ _ _ _ - .
, (Ciy) (State)
and 1 resided at _26451--Ma118t-$ AQ-~ • . However 1 have changed my damitile
(St~eet and Number) -
!o and am and have been a bona fide resident of the State of Ftorida since 18t _ day of
----_-QCtCh@r.--_ 19~Q_, and 1 reside at __-~$II.tt~ Ross Blvd
(Street and Number)
FORT PIERCE. SAINT LUCIE COUNTY, FIORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in ihe State of Florida. ~
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employment t
at former domicile, removal of family to new domicile, purchase of home, etc.) '
(Homestead Ezemption) •
20042~
fILEp ANO RE
iT.lllClE 0 _
ItOCER P01 Mt
. RECO~RED VERR
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I FURTHER CERTIFY that I will oomply with al) other requirements of a Icyal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domiGi~e, and I intend To remain in FORT
PIERCE, SAINT IUCIE COUNTY, FLORIDA, permanently. DBVid W. ~iueller
,L ' .l~c% ~.Lt.~
i~.
(Name)
~
(Address)
Swo~n to and subscribed before me this 2nd day of Yovem~er ~ 19 ?0
.
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•13~~~~'"_'~ . Notary Public
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By D.C. My Commisaion expi~es
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~ icat~ and o~inal fil~d wilh CIKk Ckwif Coue~, and dupUcal~ with Tax A~asor.)
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