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Furm 350
Neepentifically
1507237
37
Name "Cammel Thasow,
Age 44 years
Declaration ofinion. No 2514
issued by Distuit
Country Watubuy
only
14,daysof Oct. 9996
Perition, You VII No 1505
Order. signed the 15 day of
December. 9.1.1920
Name age and place ofresidente of wife:
aimue 41yro.
93 Giens Loately
Conn,
Names age and places, of residence of minor
children gest 2 0420, many
Harry 1840
munus 18yrs.
mollie 154ps
93Gheir
mmis 13ys.
St,
colby,
sadie 11 yrs.
samul Thosour
/ Signature of holder.)
New Old Na
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