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Form 390
1645219
19
Age,
Name Care august Wester
39
years
Declaration No 2844
rissued by District
waterbury
onlhe
10 day of march 9/19/7
Palition, XI No 2600
Contersigned on the 16 day of
September ,9.1921
Name, age. and plave afriie
Bd. Walathy Come
Jennine 34yrs. 42 Soultwayd
Names ages and places ofminor
children margaret 13 yrs.
Carl "yrs. arthur a yrs.
42 Souldinaya Road
Walnbury Come
Carl august wester
(Signabure of holder.)
New Old No
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Context sent to Scholar
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