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Form 3HII
818683
33
Age 30
years
Declaration ofinion. NiGoldier
issued by Clerked
of
onthe
day of
,99119
Perition, You. 10 No 1077
Contersigned the q day of
we
James age and place of residence afrife:
Bladys age 24 resides
Dirington Can
Names ages and planes infresidence of minor
children Eiklyn bone mays 1915
resides Dorington Corn
Eudrick Philip Bollass
/Siqnature of holder.)
New certificate. Na
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- Core
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Context sent to Scholar
Document identity
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Page context
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