Dane CCC R102436

Record Type: Signed Petition

Family Name: Berlova

Given Name: Marianne

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

Given Name - Alternate:

Address: 2909 Gregory St., Madison, Wis.

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

Title/Location of Court: Circuit Court, Dane

Place of Birth:

Date of Birth: 1/25/10

Certificate #: 6841139

Port of Arrival:

Arrival Date:

Naturalization Date:

Witness 1:

Witness 1 Address:

Witness 2:

Witness 2 Address:

Age:

Date of admission: 11/18/52

Date Certificate Issued: 11/18/52

Petition #: 5491

Alien Registration #: A 6637337