Dane CCC R703860

Record Type: Signed Petition

Family Name: Smith

Given Name: Ellen Justin

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

Given Name - Alternate:

Address: Madison, Wisconsin Rt. 1

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

Title/Location of Court: Circuit Court, Dane

Place of Birth:

Date of Birth:

Certificate #: 3189010

Port of Arrival:

Arrival Date:

Naturalization Date:

Witness 1:

Witness 1 Address:

Witness 2:

Witness 2 Address:

Age: 51

Date of admission: 5/19/30

Date Certificate Issued: 5/19/30

Petition #: 3146

Alien Registration #: