Dane CCC R100205

Record Type: Declaration

Family Name: Adler

Given Name: Phillip Abrams

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

Given Name - Alternate:

Address: 226 W. Gilman St., Madison, Wis.

Vol/Page (V-PG or Filed YYYY): V-5, P 71

Title/Location of Court: Circuit Court, Dane

Place of Birth: Vilna, Russia

Date of Birth: Jan. 14, 1891

Certificate #:

Port of Arrival:

Arrival Date:

Naturalization Date:

Witness 1:

Witness 1 Address:

Witness 2:

Witness 2 Address:

Age:

Date of admission:

Date Certificate Issued:

Petition #:

Alien Registration #: