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47
Name, Frank michal Butkus
Age
35 years
Declaration ofintention. No 3301
issued by of District
Court of waterary
on the
Perition, You.
4 day of may ADMIT
x An 2324
Ontersigned. the 15 daysof
march
A.1.1921
Name age and place of residence of wife:
many 36 681 No.
Waterbany et
Names ages and places of minor
children: Veadis 13 yrs. annie
10 oyrs.
650 No. Riverside st.
Waterbary Ct.
Frank", m Butkus
michael
/ Signature, of holder.)
New Old Na
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