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'Y'lib M aa~r d~elaratbn o~ Don~klls and Citis~asAJp !s tM Btal+~ ot F:xid~ tuat i ua Nia~ tAb day is ioco~d~aa. and ia ~
eaJoe~aatq w?ith S~etioa Z2Z.lT. Florida Statue«. - , ~
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IP POR TME PURPOSE OF ENROLIINti IF EOR NOMESTEAO PURPOSES~
CNILOREN IN SCHOOI.i PLEASE STATE 1?~tAS[ CMECK:
T NE 1 R N A ME S: ~ ~ ~--.-----1
• • No nr~ ~23`~'8i
' f! lE0 AND RECO~pEp
~ ' s~• ~UCIE COUIiTT fLA,
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CtRCUIT COU T -
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I FUR'1"NER CERTIE'Y tfia~ I~1 ngister d my local address ~rben tbe registrat3oa books nopea. u~d camplr +vith all
other requireaxats ot a kgal resident of th'ss State.
I FU~t1'HE~ CEBTIFII that I bave ao intentio~n to r+etura to tormer domiak. and I tntead to nmai~ in
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Florida. permanencl;
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. E P U T Y l E R K BOOK 2~~ PACE ~V'~
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