Dane CCC R101534

Record Type: Petition

Family Name: Backstrom

Given Name: J.M.

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

Given Name - Alternate:

Address: Stoughton, Wis.

Vol/Page (V-PG or Filed YYYY): A5-20

Title/Location of Court: Municipal Court, Dane

Place of Birth: Sweden

Date of Birth:

Certificate #:

Port of Arrival:

Arrival Date:

Naturalization Date: Sept. 6, 1904

Witness 1: H.A. Huber

Witness 1 Address: Stoughton, Wis.

Witness 2: M. Johnson

Witness 2 Address: Stoughton, Wis.

Age:

Date of admission:

Date Certificate Issued:

Petition #:

Alien Registration #: