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Form 390.
1143466
16
Necopertifically
Name
Age, 31
John Stevens
years
Declaration of intention. No 2517
issued by of Distud
Court of Waterbary
onlhe
14 day of out ,991916
Perition, Vil. 6 No 1457
the 15 day of
march 0191919
Name age and pluce of residence afriie:
Wolcott It. Watertary love
Jannie , 28 years 60
Names ages and places of residence
children
mayarit 8years / 60 W alatt it whity It
Dahn L y 16 / 11 11 LL " 11
Genge 4 months 11 " 11 " LI,
Signatuie of holder.)
New bld cerlificale. rigonn Stevens
Certificate To. 114346 EReceived
Date John Storons april 1919
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"ocrText": "Form 390.\n1143466\n16\nNecopertifically\nName\nAge, 31\nJohn Stevens\nyears\nDeclaration of intention. No 2517\nissued by of Distud\nCourt of Waterbary\nonlhe\n14 day of out ,991916\nPerition, Vil. 6 No 1457\nthe 15 day of\nmarch 0191919\nName age and pluce of residence afriie:\nWolcott It. Watertary love\nJannie , 28 years 60\nNames ages and places of residence\nchildren\nmayarit 8years / 60 W alatt it whity It\nDahn L y 16 / 11 11 LL \" 11\nGenge 4 months 11 \" 11 \" LI,\nSignatuie of holder.)\nNew bld cerlificale. rigonn Stevens\nCertificate To. 114346 EReceived\nDate John Storons april 1919"
}