Statement of male:
Full name: John S. ULICNY
Date of Birth: 31 May 1932
Occupation: drill press operator
Birthplace: Bethlehem, PA
Residence: 536 Maple St., Bethlehem, PA
Age: 22
Previous marriages: NO
Father: Stephen ULICNY
Mother: Mary (GOYER)
Residence of father: same as app.
Residence of mother: same
Occupation of father: motor inspector
Occupation of mother: housewife
Birthplace of father: Eakley, PA
Birthplace of mother: Reading, PA
John S. Ulicny (signed)
|
Statement of female:
Full name: Nancy Ann DECKER
Date of Birth: 4 Nov. 1935
Occupation: clerk
Birthplace: Bethlehem, PA
Residence: 516 Filbert St.,Bethlehem, PA
Age: 19
Previous marriages: NO
Father: Frederick DECKER
Mother: Agnes DISKANET
Residence of father: same as app.
Residence of mother: same
Occupation of father: ?machinist? (hard to read)
Occupation of mother: cook
Birthplace of father: Bethlehem, PA
Birthplace of mother: Ohio
Name of parents or guardian who give consent:
Agnes Decker (signed)
Ida M. Decker (signed) |
