Dane CCC R300304

Record Type: Signed Petition

Family Name: Gundersen

Given Name: Petra Oluffa

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

Given Name - Alternate:

Address: 1905 Pochantas Dr., Madison, Wis.

Vol/Page (Enter V-PG or Filed YYYY): 49-104

Title/Location of Court: Circuit Court, Dane

Place of Birth:

Date of Birth: 5/31/11

Certificate #:

Port of Arrival:

Arrival Date:

Naturalization Date:

Witness 1:

Witness 1 Address:

Witness 2:

Witness 2 Address:

Age:

Date of admission: 11/18/52

Date Certificate Issued: 11/18/52

Petition #: 5496

Alien Registration #: 6941144