Dane CCC R202667

Record Type: Declaration

Family Name: Goldman

Given Name: Evelyn

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

Given Name - Alternate: Evelyn

Address:

Vol/Page (Enter V-PG or Filed YYYY): See Vol 6-86

Title/Location of Court: Circuit Court, Dane

Place of Birth:

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: 6-23-71

Date Certificate Issued: 6-23-71

Petition #: 5180

Alien Registration #: