25 END
19. Names and nationality of
parents.
t
20. Names of minor children and
if they are to be included in the certificate the ir dates of birth.
21. Applicant's antecedents.
22. Whether applicant bears
a good character.
Ole Olsen Rode (father) Charitte Rode (mother deceased) Norwegians.
Per Jensen (adopted son).
Norwegians.
Yes.
Sd/ P.A.Kelly
Commissioner of Police.
True copy.
sa/
for Superintendent.