1. That petitioner’s name and post office address is t~lmer ~rnest Wilson,
1531 Cheyenne Street, Lincoln, Nebmsk~ ,andthat ___heis
informed as to the facts herein set forth.
3. That the following schedule contains the required facts relative to such person’s birth:
Color or Race_1~Li~6__Birth Year ll~5l851 Color or Race v~hite Birth Year lO~7~l5ô2
WHEREFORE, petitioner prays that the Court set this petition for hearing, take testimony thereon and
find and decree that the allegations thereof are true and certify such findings to the Department of Health, State of
Nebraska.
Dated~ii~~i,~_ 1949.
Petitioner,
or ~
1_I ~Ji~’
~
ha he s the p ti z ie &rezn that Jie as end the above a dforegoiig petition ard tiaL th allegations