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Frim 3511 35 1883585 Name Luigi Ercoli Age, 42 years Declaration ofindening No 5876 isued by District Waterbary on the 14 day of Feb Tetition, YOU No 3202 Corder. 15- day of Dec. 09919 23 lame, age and plane of voidom of wife Names ages and places of residence of minor hildren John Zime step. - child 13 yrs Frank zims step. child 10yrs. mary Ercoli 5yrs. 573 East main St. Waterbary Come luigi Eride (Signature of holder./ Wel in artificity. Aa

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