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Declarat~on of Domicil~ and Citizenship
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.nd tids ~tstewe~t r t~ b~ tat~ a~ iq A~daratio~ ~t efet~eaiM. ~trl 1~1 re~ii.~a a~i ~ielle ts tM Se~ee a~ Florida.
If for ttre ptncpose of eciirolling '
children in public school, please
state their nanes:
SefFReY f~lLe,~ ~C. ~C~.~
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` l FURTHER CEEtTIFY tAat 1 w~ n~isttr at m~ toea! ~ddr~ts~ wi~s t1~ n~btrstMe beoka t~o*t~. aoa esapi~ •itA a8 ~
~ other re+uintAtnts d a k=a! rstid~st oi tt~ 8tat~. •
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I~tJRTHER CERTIFY tAat I Aaw no iAt~Atloa to nt~ M ap t~r ~ I i~t~s~ eo te~aaia ia
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` Florida, perteutxot~.
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198Z JAN ! 2 AM i 1~ I 7
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