Dane CCC R200969

Record Type: Declaration

Family Name: Felsher

Given Name: Max

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

Given Name - Alternate:

Address: 814 Chandler St. Madison, Wis.

Vol/Page (Enter V-PG or Filed YYYY): 1 - 116

Title/Location of Court: Circuit Court, Dane

Place of Birth: Starobian, Lubian (Russia)

Date of Birth:

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 #: