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Form 390
1143549
49
Nangentifically
Age Name michael Angelegorafale
24 years
soldiers petilin
Declaration, ofinication. No 3844
issued by District
Bourn Waterbury
29 day of september, ADD
mith
Selition, You 8 No 1756
4 it days of
September 01/11/19
Name age and place ofresidente afriie:
single
Names ages and places of residence of minor
children none
(Signature of holder.)
Vin rerlifiante. Na Michael a Garofalo
Certificate No. 143549 Received
Date Sept 18
199
lardalo
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Context sent to Scholar
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