Dane CCC R200744

Record Type: Declaration

Family Name: Fagerstrom

Given Name: Gustaf Erik

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

Given Name - Alternate:

Address: 2745 Union St., Madison Wis.

Vol/Page (Enter V-PG or Filed YYYY): 16-249

Title/Location of Court: Circuit Court, Dane

Place of Birth: Solleftea, Sweden

Date of Birth: June 3, 1891

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Naturalization Date:

Witness 1:

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Witness 2:

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Age:

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Date Certificate Issued:

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Alien Registration #: