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DORFMAN, Louis
(Typewrite here the name-with surname first, given
nameslast.) Vol TX rg112
Decl TV Pg 490
(Signature here in full. Given names first.)
Age, 37
years. Petition No. 2101
Issued by District
(Title of
Court
, at
Court.)
Waterbury, Conn.
Date of order of admission
September 15, 1920.
, 19
Declaration of Intention No.
Issued by Clerk of the
Court of
on the
day of
, 19
Name, age, and place of residence of wife: Annie, 35 yrs; 21 Bucking-
ham St., Waterbury, Conn.
Names, ages, and places of residence of minor children: Pauline, 11 yrs;
May, 10 yrs; Charlotte, 2 yrs; Waterbury, Conn.
Old
No. 2788875
XXXX
Certificate No.
1393771
(Use only when new Certificate is authorized.)
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"ocrText": "DORFMAN, Louis\n(Typewrite here the name-with surname first, given\nnameslast.) Vol TX rg112\nDecl TV Pg 490\n(Signature here in full. Given names first.)\nAge, 37\nyears. Petition No. 2101\nIssued by District\n(Title of\nCourt\n, at\nCourt.)\nWaterbury, Conn.\nDate of order of admission\nSeptember 15, 1920.\n, 19\nDeclaration of Intention No.\nIssued by Clerk of the\nCourt of\non the\nday of\n, 19\nName, age, and place of residence of wife: Annie, 35 yrs; 21 Bucking-\nham St., Waterbury, Conn.\nNames, ages, and places of residence of minor children: Pauline, 11 yrs;\nMay, 10 yrs; Charlotte, 2 yrs; Waterbury, Conn.\nOld\nNo. 2788875\nXXXX\nCertificate No.\n1393771\n(Use only when new Certificate is authorized.)"
}