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{
    "localId": "159596813",
    "label": "File numbers 4874 - 5509, 1926-1930",
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    "contentType": "document",
    "title": "File numbers 4874 - 5509, 1926-1930",
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        "Naturalization Records of Non-Federal Courts in Connecticut",
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{
    "seq": 223,
    "pageIndex": 0,
    "type": "photo",
    "url": "https://s3.amazonaws.com/NARAprodstorage/lz/partnerships-0002/18-0177_US-MA/18-0177_US-MA_21/18-0177_US-MA_-4526886-CTN-Applications-for-Declaration-of--1926-1930/18-0177_US-MA_-4526886-CTN-Applications-for-Declaration-of--1926-1930_00223.jpg",
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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n4986\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\n(NOTE TO CLERK OF COURT.-To guide you in preparing the Declaration: The black face lines on this form contain\nstatements\nin the regular order as they are to appear on the Declaration of Intention.)\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMr.\nam\nMy name is\nMrs.\nJohn Stankiewicz\n; age,\nMiss\n(Alien should print or typewrite here true, original, and correct name)\n(Give age\n4746\nlast birthday) years.\nAlso known as\n(If alien has used any other name in this country, that name should be shown here)\nI° used that name because\nThe full of the Jan Stankiewicz\nname person shown on my steamship ticket was\nMy mother's maiden name was Teofila Morusz\nMy maiden name was (if woman)\nMy present occcupation is\nPorter\nMy personal description is: Color, White ; complexion, Fair\n; height, 5 feet 5 inches;\nweight,\n195 pounds; color of hair, lisht brow n ; color of eyes, sray brown;\nother scars, nose onright foretinger, on left\nvisible distinctive marks: on\nforefinger a ends of as jeft fingers\nI was born in\nWierciochi Russia now Poland\n(City or town)\n(Country)\non\nthe 16th day of March\n1878\nMy present residence is 32 White St., Norwich, NewLondon, Conn.\n(Number and street)\n(City or town)\n(County)\n(State)\nMy post office address is sameas above\nThe Bremen\nplace where I took the ship or train which landed me in the United States was\nGermany\n, on March 5 1897\n(Month)\n(Day)\n(Year)\nThe ticket on which I came to this country was bought at\nBremen, (City) Germany (Country)\nThe name of the ship or railroad on which I came was\nVictorio\n(OVER)\n614-8"
}