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File numbers 4874 - 5509, 1926-1930

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Form 2218 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 5009 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 Mrs. DANIEL WILCSYNSK j ; age, 513 years. thas (Alien should print or typewrile 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 ticket was My mother S maiden name was, My maiden nemo was (if womun) My present occcupation is Farming dark My personal description is: Color, White ; complexion, brunette ; height, 5 feet 2 inches; 1/2 weight, 148 pounds; color of hair, Black ; color of eyes, brown ; other visible distinctive marks: none I was born in Poland austria now Poland BLOCSOW , (City or town) (Country) on the may day of 7 , 1873 My present residence is Down of Eustayme, new London , / connectect (Number and street) (City or town) (County) (State) My post office address is Lyme, Comen, Bp b P.O.Box 61 The place or me in where I took the ship train which landed the United States was Hamburg, germany , on 16, (Month) May , 1906 (Day) (Year) The tickot on which I came to this country was bought at (City) (Country) The Badina name of the ship or railroad on which I came was (OVER) 014-8

Page data

Page
269
Source index
0
Type
photo
Media ID
a3d87910b5f14739
Size
unknown

Document data

ID
159596813
Core
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Type
document
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Context sent to Scholar

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    "ocrText": "Form 2218\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5009\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\nMrs.\nDANIEL WILCSYNSK\nj\n; age,\n513\nyears.\nthas\n(Alien should print or typewrile here true, original, and correct name)\n(Give age last birthday)\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 name of the person shown on my steamship ticket was\nMy mother S maiden name was,\nMy maiden nemo was (if womun)\nMy present occcupation is Farming\ndark\nMy personal description is: Color, White ; complexion, brunette ; height, 5 feet 2 inches;\n1/2\nweight, 148 pounds; color of hair, Black\n;\ncolor of eyes, brown\n;\nother visible distinctive marks:\nnone\nI was\nborn in Poland austria now Poland\nBLOCSOW ,\n(City or town)\n(Country)\non the may day of 7\n, 1873\nMy present residence is Down of Eustayme, new London , / connectect\n(Number and street)\n(City or town)\n(County)\n(State)\nMy post office address is Lyme, Comen, Bp b P.O.Box 61\nThe place or me in\nwhere I took the ship train which landed the United States was Hamburg, germany\n,\non 16, (Month) May , 1906 (Day)\n(Year)\nThe tickot on which I came to this country was bought at\n(City)\n(Country)\nThe Badina\nname of the ship or railroad on which I came was\n(OVER)\n014-8"
}