Dane CCC R101889

Record Type: Petition

Family Name: Basherov

Given Name: Samuel

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

Given Name - Alternate:

Address: 129 Orchard St. Madison, Wis.

Vol/Page (Enter V-PG or Filed YYYY): 1278 Vol 13-P 28

Title/Location of Court: Circuit Court, Dane

Place of Birth: Koshelovka, Russia

Date of Birth: Feb. 12, 1889

Certificate #: 687306

Port of Arrival: Philadelphia, Pa.

Arrival Date: Sept. 25, 1901

Naturalization Date: Nov. 20, 1916

Witness 1: A. H. Kuhlman

Witness 1 Address: 124 Breeze Terrace, Madison, Wis.

Witness 2: Roy T. Harris

Witness 2 Address: 3215 Keyes Ave., Madison, Wis.

Age:

Date of admission:

Date Certificate Issued:

Petition #:

Alien Registration #: