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~:;'Tbis is ~ d.eLns#ioo ai Domieite asd is tus 8tste d Floeid~ tLst I am ~ tbi. aq 3>.•aooo~ei.aoe. and is
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resided sI TL - - HawwQ. I Law eLa>e~sd ~7 ~o®ie11~ to _
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.arodam asd lave bees+abo®a Sd~iesidasotbltLe State dl~7ozida since - - - _ . - _ da;~ d
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gad this ststemeat is to bs tal~ea es nq dedaratioa ai citiseasLip. aetnd legal sesideaoe and domia~e is the State d 77aeida.
IF FOR THE PURPOSE OF ENROLLING ~F FOR HOMESTEAD PURPOSESa
CH 1 LDREN i N SCHOOi„a -PLEASE STATE ~t.EASE CHECK:
THEIR NANESt
. - 19TH SEP ~ 2 ~ 9: 25
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I IRJRZ'~R-(~RTIfR tLat I w~:egister at aq 1oea1 add~sss wbea the :esist~stioa boots seopea. and oomph witb atl
_ otba regmrements d a Ieaal d tbis State.
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I 1:'[1AZ'1~It ~R tLd I Lave as mtcntion to retmrn to ~
ormer~doa~~e„ and I intead to- remais is
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F`laa'ida. Pi-
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Sweestsaad sabses~ed betoe,e me tLis - ds~ d TO 2 l S I I~• V ~ I E =-~O R r 7r4-
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