Dane CCC R100530

Record Type: Declaration

Family Name: Anderberg

Given Name: Selma Lydis Carlson

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

Given Name - Alternate:

Address: Rt. 4 Madison, Wisconsin

Vol/Page (V-PG or Filed YYYY): V 19 P 25

Title/Location of Court: Circuit Court, Dane

Place of Birth: Sweden

Date of Birth: Oct. 3 1873

Certificate #: 5556 11x 77599

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 #: