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SZCZEPANSKI
(Typewrite here PRIER first, given nameslast.)
Age, Peter Signature here infull. Given
names first.)
minori Pleas years
Petition No.
,
at
Court.)
Date of order of admission
materbary 5209 IS' Com.
Issued by Court (Title of of
, 1928
Declaration of Intention No.
9748
Issued by Clerk of the
District Court of
on the
maintring
N
day of
Jan.
, 19 26 n
Name, age, and place of residence of wife:
X
Names, ages, and places of residence of minor children:
Reyniond 13yrs. Kazmierz 11yrs.
Old H. Com
No. 2850534
New Certificate No.
(Use only when new Certificate is authorized.)
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Context sent to Scholar
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Page context
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