-———‘_; - ~

Father’s: Trade.

Father’s and Mother’s Name.

-__.-‘._--

/7

fl/% ul/c////// // /

a @zz-z/Ac 7) [:7

//‘.’ /. pé/h

) ,(A/z (WA/A [861'

ZZZ'W'///7uze/Q\JZ/4:Z7411.") /

/4 ’( ’y/Z/‘lii’tl/t/ ,:(V£VJZ-Lé¢)/‘VAV

. .7 / I (‘7, yl/I( X1167“ 0/0 I. A‘ 7/2 ¢/11r1 /,

M / /’ '/ 7/c /’1/ l.

«74 /

I [A .4 7 / ./. , _, AKZI /( /'/'//1 t } ///I /1// 1 f ( 9 ll -{//A M/ /{n~)1/4(.1) flit, «W )1‘l/M) 4% 1/ /// - / 44’11/14 2’16? A214,? , 1/:3/ /}’ Aff£kfi_.-

f} é 4-4/ 7/9/1 // /

/'/z. 1 // a: 4///2/Z4 x” ' kl/‘;

A7

M

v

M/L% z.«/‘J/’/ ////14 A ,-/ 2/.- A1, /2%; 42/;‘dfigflzdatj 2% 7/{ZJ// ill/J //412_42 //}ZA 1<e2 / AA 711/?) //flAt/A // /A‘.A% //u/fl—a. ,/ , 1,. 24.14) 4“ ,2 / ////f//{/ u/ZA/A/ (,/ /fl //,.7,

" Residence.

[A1 ’4 1/

/«tld A

/

/// ZI/ 4/ g ’L/// /: ACZé'ZZ(M;AV ./94421 1' /¥; %/ (f /Z/- 17 GAZ/r‘fif’J r/_2/{xzt«4<2

chJ—‘I‘ / 75/; Zz/Z/A/ éa/Aé- Mufi z: / L/ZZ/ . z. , [$24, 1274 / /i/ /21 d..,«

J; A 77/77:; / 1/4/15,

{

/ /AL (3 o %;z (‘7 :7 . j. 2444/) / J. (1,1 [6.3.

4.. 2 7/ Z/Z/Az, Agzz) 4L. fl.g;; .77»,

_ /" ? 'A/A A; ,.,_ flAZZffl/A J

7777/ 77A A 4/ AAA-.-” AA, , 4/142 flmA/a/r [/(Z/(t )4éZ///l/ ///zr(A—~ 0/:th AAJAA , QAAZ' “/41 4247 AA; ///AZA%/u

4/4/4711! :7 A“ D I 7 ~%I* . %"L’

/A/7%24, . ’/.. 7/1741

,1é 1'ng

jA/b/

/ . C7 Zia/z z t A

“‘i’“{/f)

{4144;2/27;(a/ fl; Z/rz .Z/z 2

2", A / 2‘, C . ' :Zk:;ar. A 0

i ‘7

ZA

, J

//:l Z/é'zgt‘,’ 9514* ~4W¢fl7za Z<I~ 9

2/ 2:,14/L/j;

/ 71,; L l/ A). c (j 4/ / I 2 r) zzzzz c/ f. (2,4‘ / //14—4 «/A 2,14 ( J 7/ / 3.4 15/ /,/ ,3?