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11. We ask the Court to end our marriage and approve our marital settlement agreement. claims made in this petition and that the punishment for knowingly making a false statement includes fines and/or imprisonment. Dated - - - - - - - Signature of HUSBAND Printed Name Address City State Z i p - - - - - - - - - - - - - Telephone Number Fax Number - - - - - - - - - - - - - - E-ma i I Address es STATE OF FLORIDA COUNTY OF OKALOOSA Sworn to or affirmed and signed before me on by NOTARY PUBLIC ...

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