Dane CCC R602101

Record Type: Petition

Family Name: Seim

Given Name: Jacob Andersen

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

Given Name - Alternate: Jacob Andersen

Address: 804 Dennett Dr., Madison, Wis.

Vol/Page (Enter V-PG or Filed YYYY): 47-21

Title/Location of Court: Circuit Court, Dane

Place of Birth: Norway

Date of Birth: 9/10/07

Certificate #: 6448519

Port of Arrival: New York, N.Y.

Arrival Date: 11/27/28

Naturalization Date: May 21, 1945

Witness 1: Randolph Rosten

Witness 1 Address: Madison, Wis.

Witness 2: Olav Ballingberg

Witness 2 Address: Madison, Wis.

Age:

Date of admission:

Date Certificate Issued:

Petition #:

Alien Registration #: