Dane CCC R102461

Record Type: Signed Petition

Family Name: Berntsen

Given Name: Dagmar Ovidia

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

Given Name - Alternate:

Address: 312 North 5th St., Madison, Wisconsin

Vol/Page (V-PG or Filed YYYY): Vol.44 Page 10

Title/Location of Court: Circuit Court, Dane

Place of Birth:

Date of Birth:

Certificate #: 6019304

Port of Arrival:

Arrival Date:

Naturalization Date:

Witness 1:

Witness 1 Address:

Witness 2:

Witness 2 Address:

Age: 46

Date of admission: May 17, 1943

Date Certificate Issued: May 17, 1943

Petition #: 4780

Alien Registration #: