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File numbers 4874 - 5509, 1926-1930

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Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 5004 U. S. DEPARTMENT OF LABOR NOT TO BE FILLED IN BY ALIEN FOR USE OF OFFICIALS SEARCHING IMMI- NATURALIZATION SERVICE GRATION RECORDS CLERK OF COURT: RECORDS EXAMINED Place number in CARD INDEX upper left-hand corner of all copies of declaration, immediately under your INDEX BOOKS declaration number. DISTRICT DIRECTOR OF NATURALIZATION. MANIFESTS (NOTE TO CLERK OF COURT.- To guide you in preparing the Declaration: The black face lines on this form contain statements in the regular order as they are to appear on the Declaration of Intention.) I desire to file my Declaration of Intention (first paper) to become a citizen. Mr. My name is Mre. Ginsypina birioni ; age, 30 years. Miss (Alien should print or typewrite here true, original, and correct name) (Give age last birthday) Also known as (If alien has used any other name in this country, that name should be shown here) I used that name because The full name of the person shown on my steamship tickot wes My mother' maiden name was My maiden name was (if woman) My present occcupation is white Honockeeper wife 3/4 My personal description is: Color, dark ; complexion, dark ; height, 5 feet 4% inches; weight, 165 pounds; color of hair, dark brown ; color of eyes, darch Brown other visible distinctive marks: none I was born in Pesaro city Stalia (City or town) (Country) on the 5-12 day of guiley H gune 896 My present residence is R. of (Number D.2. street) mysti (City Graston New (County) London bern and of town) (State) My post office address 2, is Mystic cherbourg, The place where I took the ship or train which landed me in the United States was france , on Nov. 5 1913 (Month) (Day) (Year) The ticket OH which I camo to this country was bought at (City) (Country) The name of the ship or railroad on which I came was White Star Line ship Olynic (OVER)

Page data

Page
259
Source index
0
Type
photo
Media ID
a7cf95e31b99b069
Size
unknown

Document data

ID
159596813
Core
doc
Type
document
DTO data 
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Context sent to Scholar

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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5004\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 statements\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.\nMy name is\nMre.\nGinsypina birioni\n; age,\n30\nyears.\nMiss\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nAlso known as\n(If\nalien has used any other name in this country, that name should be shown here)\nI used that name because\nThe full name of the person shown on my steamship tickot wes\nMy mother' maiden name was\nMy maiden name was (if woman)\nMy present occcupation is\nwhite Honockeeper wife\n3/4\nMy personal description is: Color, dark ; complexion, dark ; height, 5 feet 4% inches;\nweight, 165 pounds; color of hair, dark brown ; color of eyes, darch Brown\nother visible distinctive marks: none\nI was born in\nPesaro city\nStalia\n(City or town)\n(Country)\non\nthe 5-12 day of guiley H gune\n896\nMy present residence is\nR. of (Number D.2. street) mysti (City Graston New (County) London\nbern\nand\nof town)\n(State)\nMy\npost office address 2, is Mystic\ncherbourg,\nThe place where I took the ship or train which landed me in the United States was\nfrance\n, on\nNov.\n5\n1913\n(Month)\n(Day)\n(Year)\nThe ticket OH which I camo to this country was bought at\n(City)\n(Country)\nThe name of the ship or railroad on which I came was White Star Line ship Olynic\n(OVER)"
}