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OCR
5406
Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
U. S. DEPARTMENT OF LABOR
NOT TO BE FILLED IN BY ALIEN
FOR USE OF OFFICIALS SEARCHING IMMI-
NATURALIZATION SERVICE
GRATION RECORDS
CLERK OF COURT:
RECORDS EXAMINED
Place number
in
CARD INDEX
upper left-hand corner of all copies of
declaration, immediately under your
INDEX BOOKS
declaration number.
DISTRICT DIRECTOR OF NATURALIZATION
MANIFESTS
I desire to file my Declaration of Intention (first paper) to become a citizen.
Mr.
My name is
Mron
Benjamin Abramchyk
; age,
32
years.
(Alien or typewrite here true, original, and correct name)
(Give age last birthday)
My present occupation is
Shoe Clerk
My personal description is: Color,
White
; complexion,
Medium
; height, 5 feet 4 inches;
weight, 124 pounds; color of hair,
black
;
color of eyes, hazel
;
other visible distinctive marks:
NONE
I was born in
StuczyN
Poland
City or town)
(Country)
on the
14
day of
May
, 1895
My present residence is
136 Broad Street Norwich NewLondon Coun,
(Number and street)
(City or town)
(County)
(State)
The place where I took the ship or train which landed me in the United States was
Hamburg,
germany
9 on
August
1910
(Month)
(Day)
(Year)
The name of the ship or railroad on which I came was
S.S. Bluecher
My last place of foreign residence was (City or term)
sailttuczyn
(Country)
I
am NoT married. The name of my
wife
}
She
is
husband
NONE
He
}
was born at
-
, and now resides at /
,
I am now a subject of and intend to renounce allegiance to
The Republic of Poland
(Write name and title of sovereign and country of which now a subject;
or, if citizen of a republic, write name of republic only)
I arrived at the United States immigration port of
New York
New York
, on
14-8 August (City or town) 12th 1910
(State or territory)
Give exact month, day, and year)
(OVER)
Page data
- Page
- 1065
- Source index
- 0
- Type
- photo
- Media ID
- 4bc4d2c61bcc2953
- Size
- unknown
Document data
- ID
- 159596813
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
Document identity
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Document source metadata
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Document source extras
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Page context
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"ocrText": "5406\nForm 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\nU. S. DEPARTMENT OF LABOR\nNOT TO BE FILLED IN BY ALIEN\nFOR USE OF OFFICIALS SEARCHING IMMI-\nNATURALIZATION SERVICE\nGRATION RECORDS\nCLERK OF COURT:\nRECORDS EXAMINED\nPlace number\nin\nCARD INDEX\nupper left-hand corner of all copies of\ndeclaration, immediately under your\nINDEX BOOKS\ndeclaration number.\nDISTRICT DIRECTOR OF NATURALIZATION\nMANIFESTS\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMron\nBenjamin Abramchyk\n; age,\n32\nyears.\n(Alien or typewrite here true, original, and correct name)\n(Give age last birthday)\nMy present occupation is\nShoe Clerk\nMy personal description is: Color,\nWhite\n; complexion,\nMedium\n; height, 5 feet 4 inches;\nweight, 124 pounds; color of hair,\nblack\n;\ncolor of eyes, hazel\n;\nother visible distinctive marks:\nNONE\nI was born in\nStuczyN\nPoland\nCity or town)\n(Country)\non the\n14\nday of\nMay\n, 1895\nMy present residence is\n136 Broad Street Norwich NewLondon Coun,\n(Number and street)\n(City or town)\n(County)\n(State)\nThe place where I took the ship or train which landed me in the United States was\nHamburg,\ngermany\n9 on\nAugust\n1910\n(Month)\n(Day)\n(Year)\nThe name of the ship or railroad on which I came was\nS.S. Bluecher\nMy last place of foreign residence was (City or term)\nsailttuczyn\n(Country)\nI\nam NoT married. The name of my\nwife\n}\nShe\nis\nhusband\nNONE\nHe\n}\nwas born at\n-\n, and now resides at /\n,\nI am now a subject of and intend to renounce allegiance to\nThe Republic of Poland\n(Write name and title of sovereign and country of which now a subject;\nor, if citizen of a republic, write name of republic only)\nI arrived at the United States immigration port of\nNew York\nNew York\n, on\n14-8 August (City or town) 12th 1910\n(State or territory)\nGive exact month, day, and year)\n(OVER)"
}