5/6/2013 3:34 AM
[Top left, across]
Police Commissioner ANTWERP CITY
? th section
Living place : Longue rue Sainte Anne, Nr 32
1. Identity information of / Surname and Given name / Date and place of birth (Country, Province, State, Area / Current place of residence / Comments
The alien / Boxenbaum, Max/ Warsaw (Poland) Russia, May 20, 1881 / Antwerp
His wife / Cohen, Minna / Bendin (Poland) Russia, September .., 1888/ Antwerp
2. Place and date of marriage.
New York (USA) on June 7, 1907
3. A – Given name, place and date of birth and address of head's father.
Hirsch, born in Warsaw (Russia), 48 years old, living in Warsaw (Poland, Russia)
B – Surname, given name, place and date of birth and address of head's mother.
Edelstein, Sarah, born in Warsaw (Russia), 47 years old, living in Warsaw (Poland, Russia)
5. Legal residence abroad (City, Street, Nr. If the alien is allowed to establish his domicile in Belgium, provide dates and the Royal Decree)
Warsaw (Poland, Russia)
6. Last residence abroad (Country, Province, State, Area, City, Street, Nr)).
New York (USA) 13th Street, 522