Dane CCC R101713

Record Type: Declaration

Family Name: Ballam

Given Name: Georgia Alfred

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

Given Name - Alternate:

Address: 1145 Sherman Ave., Madison, Wis.

Vol/Page (Enter V-PG or Filed YYYY): 13-169

Title/Location of Court: Circuit Court, Dane

Place of Birth: Liverpool, England

Date of Birth: Sept. 24, 1895

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 #: