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his is ~ dseLratioo d DomidM acrd ~ is t6s st,~c. d F~ida that I ass ttlint this dy is aoooedaaa, aad b
eodaedq? wkl? sae#io~ ~.iZ. l~oeida Statatsa. -
Iw?astskRatrasideatoi L~I~~7rE ~is/9~n/S ~ NEaJ Opt aadl
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and as aad bane bsea a boss Sds seddsaRdtla StaLt d Floeids siaos ~ - dq d
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p' and this statement is to be tats asap-dselaestioa d dtiseasffip. actual fetal ra~idsaas sad do~nieiM is tlrs State d Flacida. -
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- 11- FOR THE rURrOSE Oi ENROLL IN(i ! f iOR NONESTEl10 ~URPOEEE,
CHILDREN IN sCNOOL, rIEASE sTATE ?LEASE CHECKi t~`~-"'1
T ME 1 R NAME a i ~-----,-„J
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fTi~ EOE~R~~DAYA ~
ILEigt CpICIgT OOIEt
RIIRRE VERIFIED
4'6519
I FUBTHI~i CERTIFY that I wfll ret~ster at at,T local addrses when the re~etratioa boobs raope~r, end eo~mp~ wits a8
other d a kcal raaideat d this Stste.
I FURTH>~i CEBTIIPY tbd I bs~e so iatentioo to retuis to fecmer and I intend to remah in
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swag to bdors are this -f 9 dq d v •~'Ri.~
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ROGER POI TRAS. CLERK OF CIRCUIT COt~T
ST. lUG ! E COMITY, fLOR 7OA
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E'tITY LERK -