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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

Page
1119
Source index
0
Type
photo
Media ID
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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 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)"
}