Dane CCC R201460

Record Type: Signed Petition

Family Name: Fosdal

Given Name: Camilla Salmine

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

Given Name - Alternate:

Address: 104 Main St., Stoughton, Wis.

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

Title/Location of Court: Circuit Court, Dane

Place of Birth:

Date of Birth: 6/6/85

Certificate #:

Port of Arrival:

Arrival Date:

Naturalization Date:

Witness 1:

Witness 1 Address:

Witness 2:

Witness 2 Address:

Age:

Date of admission: 5/19/52

Date Certificate Issued: 5/19/52

Petition #: 5469

Alien Registration #: A3 028 783