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Form 3511
2107164
14
Name Joseph years Bluengya
Declaration No 872
issued by
15th day of harmly 9.19.1921
Rachult cean on the
Centy
Perition, You. 4 No 553
Erder. signed the Lad day of
19.19.24
NAME, ago and place, of visidence, of fire
Names agescuppless of residence cofminor
children Hilen age 18ya Lithuania
Mary agr My Haiffas, it
Maighutt. 15gre
e
,
Annis age
is
Thank agri light
agui Car Sare
"
u
"
I'
goston Brunniza
/Signatire of holder.)
New Old cerlifiante. Na
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Context sent to Scholar
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