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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
4887
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.
martha anna Planm.
; age,
40
years.
Miss
(Alien should print or typewrite hero 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' maiden name was
My maiden namo was (if woman)*
My personal description Color, white fair ; complexion,
My present occcupation is housewife
is:
; height, 5 feet 11/2 inches;
weight, 190 color of hair,
color of
other
visible distinctive pounds; marks: Bremen moleon left ; cheegray eyes,
;
I was born in
(City or town)
Germany
(Country)
on the 19
a
day of
January Storington Road,
My present residence is
nornch
Conn
(Number and street)
(City or town)
(County)
(State)
My post office address is
The took the or me in the
place where I ship train which landed United States was Bremerhagen,
Germany
, on
(Month)
(Day)
(Year)
The ticket on which I came to this country was bought at
(City)
(Country)
The Steemer Main
name of the ship or railroad on which I came was
(OVER)
o14-
Page data
- Page
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- Source index
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- Type
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- Size
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Document data
- ID
- 159596813
- Core
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- Type
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DTO data
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Context sent to Scholar
Document identity
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Page context
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"ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n4887\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.\nmartha anna Planm.\n; age,\n40\nyears.\nMiss\n(Alien should print or typewrite hero 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' maiden name was\nMy maiden namo was (if woman)*\nMy personal description Color, white fair ; complexion,\nMy present occcupation is housewife\nis:\n; height, 5 feet 11/2 inches;\nweight, 190 color of hair,\ncolor of\nother\nvisible distinctive pounds; marks: Bremen moleon left ; cheegray eyes,\n;\nI was born in\n(City or town)\nGermany\n(Country)\non the 19\na\nday of\nJanuary Storington Road,\nMy present residence is\nnornch\nConn\n(Number and street)\n(City or town)\n(County)\n(State)\nMy post office address is\nThe took the or me in the\nplace where I ship train which landed United States was Bremerhagen,\nGermany\n, on\n(Month)\n(Day)\n(Year)\nThe ticket on which I came to this country was bought at\n(City)\n(Country)\nThe Steemer Main\nname of the ship or railroad on which I came was\n(OVER)\no14-"
}