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Form 390.
16
Name Slucekple 1175866 Scaretta
Age, 31
years
Declaration No395
issued by Cherke of Disluit
Count appointment
on the
4 day of april 9/9/1917
Patition, You VII No 1685.
Ondersigned.com the 15 day of
December
Name age and place ofresidence of wife:
Placida 33yro
/ 45 Locust St. (valuburary
Come
Names agesuad of residence commence
Julies Syr
Maria 4yro
autonio 2yro.
145. Locust St.
Waterbay Come.
giusippe / Sciarretta
Signature of holder.)
New Old No
Certificate No. 1175866 Received
Date Febs 3
1921
Birscoppeseionetts
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"ocrText": "Form 390.\n16\nName Slucekple 1175866 Scaretta\nAge, 31\nyears\nDeclaration No395\nissued by Cherke of Disluit\nCount appointment\non the\n4 day of april 9/9/1917\nPatition, You VII No 1685.\nOndersigned.com the 15 day of\nDecember\nName age and place ofresidence of wife:\nPlacida 33yro\n/ 45 Locust St. (valuburary\nCome\nNames agesuad of residence commence\nJulies Syr\nMaria 4yro\nautonio 2yro.\n145. Locust St.\nWaterbay Come.\ngiusippe / Sciarretta\nSignature of holder.)\nNew Old No\nCertificate No. 1175866 Received\nDate Febs 3\n1921\nBirscoppeseionetts"
}