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ss 1. (street Address or taliOn) County: (Ch) Dales you vie be at Ns address: From: (Slats) PO) To: 2. (Street Address or location) (Cis) Oates you will be at Ws address: From: (Slats) (Zip) To: County 3. (Sweet Addresses location) County: (Ch) Dales you we be at the address: From:
eight: 180 lbS Halt State Cry Officer Name: Grey Phone ( Officer Name: Phone: ( ) Officer Name' Canty Pl,nne ( ) Eyes: roue Out of State Travel Information (Complete If permanent, temporary, or transient address Is out of state) O Permanently leaving Florida to establish a residence in another stale/co
mber: 73274 Temporary Addresses U I do NOT have a temporary address 1. 22 Avenue Foch 2dd Paris YY 00000 (Skeet Address) County: Pads (City) Oates you will be at ells address: (Slate) (2P) From: To: 2. 49 Zorro Ranch Rd Stanley NM 87056-9743 . (Steel Address) County Santa Fe (City)
sees Probation Type: O State Officer Name. O Federal O County Officer Name City Deicer Name Phone Phone ( ) Phone ( ) County Out of State Travel Information (Complete if permanent or temporary address Is out of state) • Permanently leaving Florida to establish a residence in another stale Temporarily l
seet Actress) _ _ ___. _ C:.ty) MOO Po) County Dares you will be :it !his aidress: From Ta 3. rstruet /tidiest (C111) (State) WW O-Our!? Oates you will be at tile Ilddrecl: from Ta 4. . l',,'et! Addre”) (Coy) Mee) (Zip) Count) Dates you wil be at this address: From: Ta 5. r Sr far
e Hair Grey Eyes: Blue Fl. Officer Name: Sloane Phone: Stale Officer Name: Rowe: ( ) City Officer Name: Phone: ( ) County Out of State Travel Information (Complete if permanent or temporary address is out of state) D Permanently leaving Florida to establish a residence in another state El Temporarily
Entities connected to both Oates and State Travel Information

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