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Furm 3511 Neepentificate 1711352 2 Name George Woolley Age, 34 years Declaration ofintencion. No. 5344 issued by District Court of exterbary onlhe 28 day of may AD19 19 Pertion, You. XII No. 2769 Endersigned.com the 15 daysop march A91922 Name age cand place of residence of wife: Sydia 36 yrs. 7 Lewis El. Names, of residence ofminor nang atucp. A children none George Woolley (Signature. of holder.) New Old certificate. Na

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Document data

ID
159588730
Core
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Type
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Document identity
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