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Devery, (Typewrite here the name-with John surname given rolxII names last. rg 41
Age, John years. Devery Petition No. Signature here 5026 in full. Given Decl names first.) XI Pg Court 485
Common Pleas , at
Issued by (Title of of
Come
Court.)
Date of order of admission
Declaration of Intention No.
Janu 167
,1948
Issued by Clerk of the
District Court of
on the
,
day of
waterbury
Name, age, and place of residence of wife:
aug.
, 19 % 21
Names, ages, and places of residence suigle of minor children:
x
No. 2650224
Old
New Certificate No.
(Use only when new Certificate is authorized.)
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Context sent to Scholar
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