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Form 390.
1143455
5
Naportifically
Name Guiseppe Venula
Age 30 years
Declaration No 22250
issued by of Ristrict
of U.S. Eastan Distus of
new York, Brooklyn 11.4 on the
8 day of Dec 919.1911
Perition, You 6 , No 1426
Criden the 15 day of
march
19.1979
Name age und place of residence of wife:
none
Names ages, and places expresidence,
children
none
Giurseffe /Signature Venuta of
holder.)
Viga Cer tificate No. 10434557 Received
Old No
Date mark 29
1999
Gimsyle Venuta
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