Dane CCC R102426

Record Type: Declaration

Family Name: Berkhout

Given Name: Christine Marie

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

Given Name - Alternate:

Address: 427 N. Butler St., Madison, Wis.

Vol/Page (V-PG or Filed YYYY): 13-51

Title/Location of Court: Circuit Court, Dane

Place of Birth: Malang, Dutch East (Indies)

Date of Birth: July 13, 1893

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 #: