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OCR Page 1 of 235302634
34
Name fourth Symonatic
Age 33 years
exintencion, issued by derkief
superior
Not
page
on the
10 day of Feb. , ADD1010
filed on the 23 day of muh
ADDIVAR 3
page 363
Name, age and place, ofresudence of wife:
mary Cybutchiage vg
resides an Torrington Coin
Names ages and places of residence, ofminor
children Joseph boun July 9. 1905
amistorm apr. 20, 1907 Cashmier
form Jan, 25,1909 magdelina bow Jan.
20,1911 reside Tomington Come
Yel
Dale forder Oct. Vc 1912
3
page 363
dymonotis
|
joung
/Signature of holder.)