HomeMy WebLinkAbout1651 \
D~cla~atb+n ot Do~nicll~ a~d Citls~nship 152.58'7'
TO THE STATE AND COUNTY TAX l~?SSESSOR, ~
Sj. LUCIE COUNTY, RORIDA:
This is my dscla~ation of Domicile and Citi~nship in th~ Staro of Florida that 1 am filin~ thia day i~ aooordano~ end
in oonformity with Chapter Z2Z. Section Z2?.17, florida Statut~s. _
1 was formerly a leyal rosid~nt of ~batlOO Nerr Ham~4hi rA
~ty~ (Stah)
and 1 rosidad at 2 MesQ~ egp* St rp~t . How~vsr 1 haw chanp~d my domid~
(Sh~t and Number)
ro and am and have been a bo~a fide ~esident of the Stst~ of Florida sinos lSth day of
Ft.Pierce Bivd, Lakewood Park
April , tq66 , and 1 resids at Rt 2 Box
~f and Numb~r)
FORT M~, SAINT Lt1C1E COUNiY, lLORIDA
and this statsment ia ro be taken as my decla~ation of dtiunship, sctual ipal raidaxe and domidle in the Stste of Florida.
pnse~t hero any pertinent facts, such as sale of propKty or bu:inKS, or nlinquishn+ent of ~mploymant
at former domicile, removal of family to new domidle, purchase of Iwme, etc.)
Rf ~
Bstablishing residence gT~~~~EN~4 a
RECORD V~RIFI~~''
~l F 15~8~
EB e P~ 1: 2Y
AOGE`R~~
- ~~RK ~~R ~ T COURT
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~ I FURTHER Cf~tTIFY that ! will aompl with all otFw~ requirorr~ents of a lepal resident of this State.
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1 FURTHER CERTIFY that I hsve no intention to retum to my former domic,ile, and I intend to remain in FORT
PIERCE, SAINT WCIE COUNTY, FIORIDA, permanently.
.:i11N:t;J~
, Y.Ch i/jI • .
~t~J ~ V /~.!t~~l/r'~'"`~ .
• . :~~.1's~ , ff~. _ n1e
_ : - ° . " . ~ <i Harold 1~;° ~ Butman
- ;;t.';`,~';`~-;.
~ _ _ _ ~ ! ~1, i . . ~ ~~e.~.~~ak/ - -
- ~L- (~ddc~dx wife
=~Y~•~'.`;'" ~fp•' Florence G. Butman
Swarri `fo and wbsc.~ibed bafore me fhis 8th ~y - Feb~ , 19_b~.
ROSER rO1TRAt
C~C1jR C~URT Notsry PuWic
By o-t-~l.(i ~ D.C. My Commitsion expims
Ro i~ ~arhd M d~pNca1~ and o~iaieal Al~d wi11~ CI«k qrarlt Cewt, aed ~ wilb Tax As~J
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_ ~ a~ 164 ~1649 . - - _
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