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No. 7565092
VOL. 79, Pg.64
Name TISHUE, Alice Anne
74
residing at xx Bronx Ave. Waterbury, Connecticut
Date of birth July 5, 1918 ate of order of admissior Oct. 29, 1957
Date certificate issued October 29, 1957
by the
SUPERIOR
Court at WATERBURY, CONNECTICUT
Petition No. 5964
Alien Registration No. A 624 0094
Dilice anne Tishue
(Complete and true signature of holder)
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Document identity
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