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Form 390.
1143477
27
Age 37
Name John alegi
years
Declaration ofintention. No 1609
issuedly of District
Waterial
on the
2 day of see
Perition, You 6 No 1468
Crden signature the is dayof
March
09.1914
Name age and place of residence of wife:
Deceased
Names agesand places of residence
children Romeo 14yrs, Charles
a years, Domenics 4 years,
114 High St.
Watering Com
John
Alege
Signature of holder.)
New Old cerlifionte. Na
Certificate No 1143477 Receiped
Bate May 28
1919
form Alegi
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