Dane CCC R203048

Record Type: Declaration

Family Name: Grischevitz

Given Name: Nikita Fedorov

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

Given Name - Alternate:

Address: 816 Chandler St, Madison, Wis.

Vol/Page (Enter V-PG or Filed YYYY): 18-298

Title/Location of Court: Circuit Court, Dane

Place of Birth: Strobin, Russia

Date of Birth: Apr, 14, 1885

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: 8-18-41

Petition #: 5520

Alien Registration #: