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______.OOUNT7l. FLORIDA:
~:;'lbis is q deeLralia ~ gad is tIN &at~e of l`7orida tLst I a~ ffiE this dq it aeoofdaaee. iad it
• _ cottarmib wltL S~etiot ~t.1T. Florida StstWtss.
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' I wss i finer a kEat raid~st at E~~~m~aPE' A Ie~AN~ aid I
• ICI4) 1staW
resided st 8/ 7 3. /?cB~Y~ .r Ho~ws~er, I Law
t~~ a~i Ii..~Mtt eLaorsd mT dortieRe to
sod am and Baas beet s boas Bdt resided d tLe 8tst~ dFlorids shoe t~ da,T d
• ~rAY , i~ 7 8'.. anal ~a.~c X30 ,cg~-Ac~ ~4Pi
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o~eT !'iE-RCE ST. lUG ! ~••aN•~
. ~ Cooat,T' Fla"a''
and this statement is b be tal~eo as ~ deelarstioe d dtiseasLip. aetnal legal resideaoe sad daaieile fie the Ststa d Ffoeids.
!f fOR THE-PURPOSE Of ENROLLtN6 If fOR HOMESTEAD PURPOSESi
CHILDREN tN SCHOOI~ - PLEASE STATE PLEASE CHECK:
THEIR NANESS
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I FtJRTI~i ~TII~'Y tisst I w~ rem st ml foal address wlea the regajtratioa boats s+eopeo, and coooplT with sD
other regoiremeats d a kcal :esideat at tLis State.
I F'gATlll~ t~ItTII~'Y thst I bs~re oo ioteatim to ntuso to former domieiie, gad I iatead_ to nemaio io
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b'lorida, permaoeac~;. - .
1919 Alai 3 f AM ~ 57
ST~RfCY~ 0•
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t'IRCtI1T COtNtT
REPRO VE1gF1E0
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g..e~stoaad sab.ab.d before me this / s % daT at _ ~v IQl` P E,~~E FIR . 3 ~ y Sa
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