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Antonio Di Crosta
DiCROST (Typewrite here A, the name-with ANTONIO surname first, given names last.) VolxxvI rg68
P ,
Common Pleas years.
Age, 29
(Signature here in full. Given names first.)
Petition No. 5258
Issued by Court (Title of of
, at
materbusy
Com.
Court.)
Date of order of admission
, 19 28
Declaration of Intention No.
Issued by Clerk of the
a. S. Discrict 6 Court of new Sept. 12169 Haven County
on the
day of
, , 19 24 24
Name, age, and place of residence of wife:
Names, ages, and places of residence puigle of minor children: :
X
Old
No. 2882117
New Certificate No.
(Use only when new Certificate is authorized.)
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