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If by ship: Name of steamship line was the 2d 1st cabin cabin 3d oabin I arrived as (passenger, stowaway, seaman, member of crew, or otherwise) (State which) I traveled on (an immigration visa, a passport, a permit) (State which) I paid head tax at , on (State amount) (City) (State or country) (Month) (Day) (Year) I was examined by immigration officers at At that time I intended to remain (permanently, temporarily, for visit, in transit) (State which) The person in the United States was coming to was (dive name in full) The place in the United States I was going to was The names of some of the persons or passengers I traveled with were said My last place of foreign residence was Town of Burl Wkielka (Country) (City or town) wife I am yes married. The name of my is ghusband Custions Polant and now resides at Agnes Bigos He She was born at nonwich, Conn. , said Pewel Hieka I am now a subject of and intend to renounce allegiance to 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 (City town) York or new (State or territory) state on april, (Give exact month, 2nd. day, and year) 1904 York city 9 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) Carrade (b) The place in 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 The place in Mexico where I bought my railroad ticket to come to the United States was your Bigos e14-8 (Signature of applicant) (OVER)

Page data

Page
120
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 metadata
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Document source extras
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Page context
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    "ocrText": "If by ship: Name of steamship line was\nthe 2d 1st cabin cabin\n3d oabin\nI arrived as (passenger, stowaway, seaman, member of crew, or otherwise)\n(State which)\nI traveled on (an immigration visa, a passport, a permit)\n(State which)\nI paid\nhead tax at\n, on\n(State amount)\n(City)\n(State or country)\n(Month)\n(Day)\n(Year)\nI was examined by immigration officers at\nAt that time I intended to remain (permanently, temporarily, for visit, in transit)\n(State which)\nThe person in the United States was coming to was\n(dive name in full)\nThe place in the United States I was going to was\nThe names of some of the persons or passengers I traveled with were\nsaid\nMy last place of foreign residence was\nTown of Burl\nWkielka (Country)\n(City or town)\nwife\nI am yes married. The name of my\nis\nghusband\nCustions Polant and now resides at\nAgnes Bigos He She\nwas born at\nnonwich,\nConn.\n,\nsaid Pewel Hieka\nI am now a subject of and intend to renounce allegiance to\nPoland\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 (City town)\nYork\nor\nnew (State or territory) state on april, (Give exact month, 2nd. day, and year) 1904\nYork\ncity\n9\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)\nCarrade\n(b) The place in\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\nThe place in\nMexico\nwhere I bought my railroad ticket to come to the United States was\nyour Bigos\ne14-8\n(Signature of applicant)\n(OVER)"
}