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• 45'7641
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5~. LUG 1 E OOUNTY. FLORIDA: ~ .
F!'bb is aq d Damieiis aad is tbs Stag d I+7orida that I ~ ~ this dad is'aeoo~daaee. iud is
. _ooato~ wNi Seelios l4E.1T. Florida 8tstatas.
V • }I was ~r a kpl tesideet ai ~ o c,~,~, c T~P ~ ~
W~ o aed I
~esided at r] ' S y ~ n L k S - Aowe,rer.2 bare ehaa~sd a4 dotaidM to
f8d.~iasil~lrriaise! -
.and amend Lars been a bons fide sesideat dtbe Stab d Florida siooe Q
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il.~.. aodlresideat ~ ~ ~ P..a~.~l
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~T P ~ e R c p, _ ST. LUG 1 E Coont,Lh7orda.
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aad Ibis sbbmmt is b be ta]Cea as ~ deelsration d eitiseasbip. actual keel residence aad domial~e la the Stab ai T•'lorida.
IF iOR THE PURPOSE Oi ENRO~L.ING IF iOR-HOMESTEAD P.URPOSESa
CHILOREM IN. SCNOOt.~- PEASE STATE PEASE CHECKS
THElR NAMES:
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I FURTREK'C~'Y that I w~ at m~ bu1 address whey the ~ hood reope4 and ~DmP~7 with ~
other regoiremasts d a leaai rnideat ad this State. .
11`'dA1~ (;F.It'l7IR that I hae nw iateation to return b ioraxr domie~e. and I iatend b remain im
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