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Firm 3HII 40 1883590 Age, 43 years Name Carmine Squandright Declaration No 6580 suedly I -istrict ourtof Waterbary on the 26 day of Feb AD1921 Velition, Yol. XIII No. 3209 the 15 dayal Dec. A.1.1923 Jame, age eand place of residence, of wife: Names, ages and places of residence, of minor bildron Cellegions 10 yrs. aubnette 8 yrs. amiello 6 grs Cornine 1703 4yro Lakewood alda 2 yrs Road materbury Come commine squatriglia (Signature of holder.) chectificate No

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