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Page 1119 of 1298
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I have
used another name in this country than that given at the beginning of this form. If so, it was
I used that name because
The name of the person on my steamship was
full shown ticket Emma Smith
My mother's maiden name was Elizebeth Beyan
My maiden name was (if woman)
Enama Smith
mansfield Training School
My post-office address is mansfeed Depart
Cegan
Boys)
The ticket which I to this country bought C Burnley (City)
on came was at
England
(Country)
If arrival by ship: Name of steamship line was White Stur Line
1st cabin
2d cabin
2d Cabin
3d cabin
I
arrived as (passenger, stowaway, seaman, member of crew, or otherwise) Lassenger (State
which)
I traveled on (an immigration visa, a passport, a permit)
hasport
(State which)
I paid (State amount) head tax at Burmley (City)
$4.508
Langland
(State or country) , on Sept (Month) (Day) B 1919 (Year)
I was examined by immigration officers at new Year
At
that time I intended to remain (permanently, temporarily, for visit, in transit)
Permanently
(State which)
The in the United States I Rebecca Stadurd
person was coming to was
(Give name in full)
The place in the United States I was going to was
Pharwich
The names of some of the persons or passengers I traveled with were) Straveled alone
ADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME FROM OR THROUGH CANADA OR MEXICO:
(a) The place in Canada where I landed was
, on
(Month)
(Day)
(Year)
(b) The place in
{
Canada
from which I entered the United States was
Mexico
(c) On
(Month)
(Day)
(Year)
(d) The place where I was examined for admission at the United States border was
(e) If not examined, state why, and give the circumstances of your entry
Canada
(f) The place in
Mexico
where I bought my railroad ticket to come to the United States was
miss Emma Smith
GOVERNMENT PRENTING offica 14-8
(OVER)
(Signature of applicant)
Page data
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- Source index
- 0
- Type
- photo
- Media ID
- 002432ad0b8fdaab
- 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": "I have\nused another name in this country than that given at the beginning of this form. If so, it was\nI used that name because\nThe name of the person on my steamship was\nfull shown ticket Emma Smith\nMy mother's maiden name was Elizebeth Beyan\nMy maiden name was (if woman)\nEnama Smith\nmansfield Training School\nMy post-office address is mansfeed Depart\nCegan\nBoys)\nThe ticket which I to this country bought C Burnley (City)\non came was at\nEngland\n(Country)\nIf arrival by ship: Name of steamship line was White Stur Line\n1st cabin\n2d cabin\n2d Cabin\n3d cabin\nI\narrived as (passenger, stowaway, seaman, member of crew, or otherwise) Lassenger (State\nwhich)\nI traveled on (an immigration visa, a passport, a permit)\nhasport\n(State which)\nI paid (State amount) head tax at Burmley (City)\n$4.508\nLangland\n(State or country) , on Sept (Month) (Day) B 1919 (Year)\nI was examined by immigration officers at new Year\nAt\nthat time I intended to remain (permanently, temporarily, for visit, in transit)\nPermanently\n(State which)\nThe in the United States I Rebecca Stadurd\nperson was coming to was\n(Give name in full)\nThe place in the United States I was going to was\nPharwich\nThe names of some of the persons or passengers I traveled with were) Straveled alone\nADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME FROM OR THROUGH CANADA OR MEXICO:\n(a) The place in Canada where I landed was\n, on\n(Month)\n(Day)\n(Year)\n(b) The place in\n{\nCanada\nfrom which I entered the United States was\nMexico\n(c) On\n(Month)\n(Day)\n(Year)\n(d) The place where I was examined for admission at the United States border was\n(e) If not examined, state why, and give the circumstances of your entry\nCanada\n(f) The place in\nMexico\nwhere I bought my railroad ticket to come to the United States was\nmiss Emma Smith\nGOVERNMENT PRENTING offica 14-8\n(OVER)\n(Signature of applicant)"
}