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Form 390
1143468
18
Necordificate
Name
Peter Pole
Age, 3 a years
Declaration of intention. No 2556
issued by District
Courtof Waterbury
anthe
17 day of of ADDIE
Pertion, Yoil. 6 No 1459
Contersigned. the 15 day of
March 0991919
Name, age afterio
Carmella, 20 years, 14 teffrey
Names ages and places of residence
alleygle alectring Come
childyen Jennie, 7 months
14 effey alley
Walesting com
Peter Pace
(signature of holder.
New Old certificate. Na
Certisy 1143462 Received
Date Madd 29
Peter Back
1919
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"ocrText": "Form 390\n1143468\n18\nNecordificate\nName\nPeter Pole\nAge, 3 a years\nDeclaration of intention. No 2556\nissued by District\nCourtof Waterbury\nanthe\n17 day of of ADDIE\nPertion, Yoil. 6 No 1459\nContersigned. the 15 day of\nMarch 0991919\nName, age afterio\nCarmella, 20 years, 14 teffrey\nNames ages and places of residence\nalleygle alectring Come\nchildyen Jennie, 7 months\n14 effey alley\nWalesting com\nPeter Pace\n(signature of holder.\nNew Old certificate. Na\nCertisy 1143462 Received\nDate Madd 29\nPeter Back\n1919"
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