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Form 3HII
Neefectificate Herr Perhaus meris 9
1250108
Aye 28 years
Declaration No 3906
issued by Clerkol Distoger
Counts intractions
onthe
22 day of October
Pertion, Vol IX No 2053
Ondersigned. the 15 day of
march 0991920
Name age and place unwife:
none
Names, ages
children
none,
Gomes Hear / Signhture of holder.)
New Old Na
Certificate No. 1250109 Received
Date april 22 , 1030
games
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Context sent to Scholar
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