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Furm 3911
1360361
11
Huny andin
Ane 49. years
Indaration of intention. 163466
issued by Clerken District
Court of Walebury
19, day of may 9/19/7
Perition, Vill VIII No 1898.
the
15
day of
march
99900
NETA age of wife:
Corline 3%ys
66
Names efforidence of minor
children
none
/ Signature of molder!
New Old Na
Certificate No. 1360361 Received
Date april 16
1920
Josepin Heury asselin
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Document data
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Context sent to Scholar
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