Dane CCC R600918

Record Type: Declaration

Family Name: Sandsmark

Given Name: Sever Bertsen

Family Name - Alternate (X- Name at top of card):

Given Name - Alternate:

Address:

Vol/Page (Enter V-PG or Filed YYYY): Vol. A3/Pg. 459

Title/Location of Court: Municipal Court, Dane

Place of Birth: Norway & Sweden

Date of Birth: Oct. 18, 1900

Certificate #:

Port of Arrival:

Arrival Date:

Naturalization Date: Oct. 18, 1900

Witness 1: Ole Elvekrog

Witness 1 Address:

Witness 2: A. T. Torgeson

Witness 2 Address:

Age:

Date of admission:

Date Certificate Issued:

Petition #:

Alien Registration #: