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Home My WebLink About0966 . . ~ • t . . . 5, Decla~ation of Domicile and C~tizenship ~ 59~50~9 ror~c~co~~scs~curroovar, . vourrt~r. ~onm~ 7'I~b M ay d~dwtk~ ~1 OMie~ at~ ~ i~ t!» Stat~ ~f ~loeid~ t1~st t as Qfin~ t1~Y dp b~eeordsaa. aad i~ ~oaloraiK~ writl ~lo~ !l~.17. ~'fori~ 8eat~tt~s. ~ t was lormet a lnd t~aid~at et , .,t~~~„C" n~~ ' aod I . I~) ~ t~wi . nsided at ~ S1'~ ~ L`~ - ~se I lur~ ebae~ed ~ domicib te I~t a~ Ms1M1 aad u~ aad ba~~ Mu a tioaa ~ t~sidhR dtl» 8tat~ ~t!'lorid~ siaa ~ j q 7~ ~s ~f da~ a~ ~ 6/~ g , ~~..oai~a..~ ~6 ~1.L~~ C~~~5'`c,a5~~ ~ s tOtrMt d N~1~1 - ~~c~~ ~~~'t~ L, ~ ~c~~ , c~oy. ~e.. ~a~+ - _ ane etd. staaa~est b te e~ eat.s a~ ay d.e~laratto. o~ dets~n.~~. aetu.11~a1 raidene. a,~d doa~idl. is tLt saa ad F9ortds. If far the p~urpose of enrolling children in public school, please state their nanes: I • . I FUR7'HER CEATI~'Y tsst I w01 ~e st ioral address ~r6e~ tM n~idratioo books seopta, aod ootnpl~ writb all ~ otMr rpuirna~w ~l ~ lepi »sidut ~ tWi 8tat~. ~ t~'ITRTHEA C~R7'I~Y ~ tlut 1~aw ao istentioa te reeon t~e aq t~mer doaieD~. aad I~bnd b nmaia in . c•ounlr. lQt~l • - t~a~. . . ~3 FEB -1 pM. 2~ I 2 . <<C~C tNf ~~CG?: f l ST. i UCIF CO!;K' ± s ~ h. R(`G!'R f'01 ~ f%,: S ~ UNr E~?S ~I~CUF? !'G:F 7 . ~~\~~,r_.~.. _ y ~ , . . - ~ t . . ~ ; - , ~ _ - ~ ' ``<.^cu::~ ? + _ • N~ne - ~ _ Na~e - flrint e~ aaa arb~cr8~i b~J~t+~ w~ ~q ? , • ~ N~ne - s A.D. 3f 83 ~ . • . - ~ - print Jl l~ilr. ~/IJ~JI~ll ~trl~Ji~ii~'1 . ~ + ~ D~ ~ ~ ~ . . . . . . . . - - . . _.e . ~ - - . T. . .