Dane CCC R101080

Record Type: Declaration

Family Name: Andvik

Given Name: Johannes R.

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

Given Name - Alternate:

Address: 311 N. Monroe St. Stoughton Wis.

Vol/Page (V-PG or Filed YYYY): V16 P 12

Title/Location of Court: Circuit Court, Dane

Place of Birth: Bergen, Norway

Date of Birth: June 23, 1902

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 #: