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Form 390.
1143473
23
Naolentificale
Name David Ellis
Age 30 years 4
Declaration ofinlention. No 49810
issued by of Supreme
Court of new yale Country
onlhe
22,day of June ,9.1912 ,
Perition, Yoil 6 No 1463
Intersignation the 15
march
0991919
Name. age and pilar of wife:
none
Names ages and planes infresidenm of minor
children none
David Ellis
/Signature of holder.)
old Na
Nater lificate No. 1143473 Received
Date mantha
c Savil Ellis
1919
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DTO data
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Context sent to Scholar
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