
| Name | Jerry Mikacevich |
| Current Residence | 459 3rd Avenue South, South St. Paul, Minnesota |
| Occupation | Butcher |
| Born on | 25th of February, 1894 |
| At | Croatish, Austria-Hungary |
| Emigrated to the U.S. from | Liverpool, England |
| On or about | 1st day of April, 1912 |
| Arrived in the U.S. at the port of | Boston, Massachusetts |
| On the | 10th of April, 1912 |
| On the vessel | Franconia |
| Declared intention to become a citizen | 16th day of July, 1919 |
| At | Hastings, Minnesota |
| In the District Court of | Dakota County, Minnesota |
| Wife's name | Antonia |
| She was born in | Bohemia |
| And now resides in | 459 3rd Avenue South, South St. Paul, Minnesota |
| I have | Four children |
| Information on child is as follows |
|
| Renounces allegiance to | Austro-Hungary or any independent state within the former Austro-Hungarian Empire |
| Have resided in the U.S since | 10th of April, 1912 |
| Resident of the State of Minnesota since | 1st May, 1912 |
| Petition signed | The dates are 1914 and 1921 |