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Furm 3911
1645207
7
Name Patrick keefe
Age, 34 years
Declaration ofinition. No. 2070
issued by Clerk of District
Court of Waterbay
only
30 day of agail , ,9.1915
Perition, You. XI No 2579
the
16
day of
September ,991021
Name age and place afterio
Hathanie 37 yrs 10 South St.
w ateilary. Ct.
Names of residence, of minor
children: Owen 2yrs. misbael
10 miss.
10 touch St.
Watebuny et
Catrickature /
of holder./
New Na
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