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~;~'TSis is mD deda:stioo d Domic~s asd io tLe Stay d)~aids that I am this dq is~seooedsnof. and ?s
. _ aoaiaraib wk>< seetiaa !g'l.17. Flaeida Stataya. .
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.sndaan as8 Lames beessbonatde res~Rdtbe State d)b7oridtsinoe ~1', ~ ~ dy d
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abd tlds staiemeat is to bs tale as m~ dechratioe d dtise~, aetnsl legal raidcaoe i~d do®ic~tr is tb• State d T7oeids.
1f iOR THE PURPOSE Oi ENROL~IN6 - 1F FOR HOMESTEAD 1•_URPOSES~
CNIIDREN IN .SCHOOL~-P~EASE STATE- PLEASE CHECK:
THEIR NANE~L
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I FUAT~R (~EtTg'Y tbst I w~Il sesirter st m1 local address woes the s~sg:rtrstioa books reopen, sad ~ with sD
. other rcgainmoents d s kcal resident ad this Ststt.
I FURT~ ~R tbst I bare m ialeatio~n to retnra to ioeaier domiale, and I istead to remain is
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