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1st cabin If by ship: Name of steamship line was 2d cabin 3rdcabe 3d cabin I arrived as (passenger, stowaway, seaman, member of crew, or otherwise) (State whion) passurge I traveled on a a (an immigration visa, passport, permit) permist (State which) I paid no head tax at on I was examined (State amount) I by immigration remain officers at (City) Ellis (State for or country in u. ((Month) (Day) (Year) Island, At that time to intended (permanently, temporarily, visit, transit) The person coming in the United States I was to was lasimir Cholor (State which) (Give name in full) The was was names of some of the persons or passengers I traveled with were do not remented place in the United States I going to Yourter, leome The my names My last place of foreign residence said was wife (City or town) Palmara (Country) She I au yes married. The name of my is Trukop was born at husband He Bidory, Suwalks, Palaul and Bosenel an, now resides at 342 Thounch I am now a subject of and intend to renounce allegiance to (Write name and title Palaud of sovereign and country of which now a subject; if citizen of a Republic, write name of Republic only) I or, arrived at the United States Immigration port of new York (City or 41 town) (State or territory) , on 10th of april (Give exact month, day, 1912 and year) 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) { Canada (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 (f) The place in Mexico where I bought my railroad ticket to come to the United States was Febr12 Dominik Cholodowaki GOVIBNHENT PRINTING OFNICE e14-8 (Signature of applicant) (OVER)

Page data

Page
162
Source index
0
Type
photo
Media ID
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Size
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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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