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Frim 3511
49
1987349
Name
40 years
Declaration ofinlention. No. 2418
issuedly of District
Court al Watebury
24 of June smith24
June 24,
Polition, Yol. XI No. 2581
16th days of
September ,
Name, age and place of wife:
m ary-43-
4 4 Clurry St.
Names, agesond ofresidence
Coun.
children Patrick Byno Helen
10 yrs,
Dawul 4ys. Brnaa
14r- with partules.
1645244.
Signature, of holder.
New Old certificate. No .
1987349
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