Dane CCC R200616

Record Type: Petition

Family Name: Evenson

Given Name: Anna

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

Given Name - Alternate:

Address: 507 South Baldwin Street, Madison, Wisconsin

Vol/Page (Enter V-PG or Filed YYYY): Order Book - Page 118

Title/Location of Court: Other

Place of Birth: (See other side)

Date of Birth: June 25, 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:

Petition #:

Alien Registration #: