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I have not used another name in this country than that given at the beginning of this form. If so, it was I used that name because The full nome of the person chown on my steamchip ticket wes My mothor's maiden was My maidon name was (if wolltan) My post-office address is 152 sachem st norwich Connecticut The ticket on which I Callic to this country was bought ats (City) (Country) 1st cabin If arrival by ship: Name of stoamehip line was 2d cabin 3d cabin I arrived as (passengar, etowaway, seamany member of eraw, or otherwise) (State which) Ltraveled on (an immigration viga, a passport, a permit) (State which) head tax at , on (State amount) (City) (State or country) (Month) (Day) (Year) I was examined by immigration officers atm At that time I intended to romain (pormanontly, tomporarily, for visit, III transit) (State which) The person in the United Stateg I was conning to was (Give name in full) The place in the United States I was going to was. The names of some of the persons or passengers Itravoled with were 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) (b) The place in { Canada 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 GOVERNMENT PRINTING OFFICE 14-8 (OVER) (Signature of applicant)

Page data

Page
288
Source index
0
Type
photo
Media ID
d76828de3f9ae01b
Size
unknown

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 metadata
{
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    "sourceUrl": "https://catalog.archives.gov/id/159596813",
    "contentType": "document",
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    "citationUrl": "https://catalog.archives.gov/id/159596813",
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Document source extras
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    "onlineResources": [
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            "note": "This file was scanned as part of a collaboration effort between FamilySearch and the National Archives.",
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    "recordType": "description",
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Page context
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    "ocrText": "I have not used another name in this country than that given at the beginning of this form. If so, it was\nI used that name because\nThe full nome of the person chown on my steamchip ticket wes\nMy mothor's maiden was\nMy maidon name was (if wolltan)\nMy post-office address is 152 sachem st norwich Connecticut\nThe\nticket on which I Callic to this country was bought ats\n(City)\n(Country)\n1st cabin\nIf arrival by ship: Name of stoamehip line was\n2d cabin\n3d cabin\nI arrived as (passengar, etowaway, seamany member of eraw, or otherwise)\n(State which)\nLtraveled on (an immigration viga, a passport, a permit)\n(State which)\nhead tax at\n, on\n(State amount)\n(City)\n(State or country)\n(Month)\n(Day)\n(Year)\nI\nwas examined by immigration officers atm\nAt that time I intended to romain (pormanontly, tomporarily, for visit, III transit)\n(State which)\nThe person in the United Stateg I was conning to was\n(Give name in full)\nThe place in the United States I was going to was.\nThe names of some of the persons or passengers Itravoled with were\nADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME FROM OR THROUGH CANADA OR MEXICO:\n(a) The place in Canada where I landed was\n, on\n(Month)\n(Day)\n(Year)\n(b) The place in\n{\nCanada\nfrom which I entered the United States was\nMexico\n(c) On\n(Month)\n(Day)\n(Year)\n(d) The place where I was examined for admission at the United States border was\n(e) If not examined, state why, and give the circumstances of your entry\nCanada\n(f) The place in\nMexico\nwhere I bought my railroad ticket to come to the United States was\nGOVERNMENT PRINTING OFFICE 14-8\n(OVER)\n(Signature of applicant)"
}