Dane CCC R202781

Record Type: Declaration

Family Name: Gozian

Given Name: Jakob

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

Given Name - Alternate:

Address: 620 W. Washington Ave., Madison, Wis

Vol/Page (Enter V-PG or Filed YYYY): 3-29

Title/Location of Court: Circuit Court, Dane

Place of Birth: Poillos, Austria-Hungary

Date of Birth: Dec. 24, 1882

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Port of Arrival:

Arrival Date:

Naturalization Date:

Witness 1:

Witness 1 Address:

Witness 2:

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Age:

Date of admission:

Date Certificate Issued:

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Alien Registration #: