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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5026
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.
Aleksander Podurgiel
; age,
40 39
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 ticket was Aleksander Podurgiel
My mother's maiden name was
Antonina yolenkiewicz
My maiden name was (if woman)
My present occcupation is polisher - -laborer
My personal description is: Color, white
; complexion, fair
; height,
5
feet 67 inches;
dark
weight, 160
pounds; color of hair, brown
A
; color of eyes,
blue
;
nick I other visible andlifthingers distinctive marks: soar left Russia knuckle mow middle Poland finger Scarson on back of
was born in
(City or town)
(Country)
on the 13
day of Sept.
,1
1885 7
My present residence is 46 Ward Str, Norwich, Conn
(Number and street)
(City or town)
(County)
(State)
My post office address is
same as above
The place where I took the ship or train which landed me in the United States was Hamburg, Germany
, on Oct. 7, 1908
(Month)
(Day)
(Year)
The ticket on which I came to this country was bought at New York, N.Y.
(City)
(Country)
The Victoria Louise,
name of the ship or railroad on which I came was
(OVER)
c14-
Page data
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Document data
- ID
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- Core
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- Type
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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\n5026\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.\nAleksander Podurgiel\n; age,\n40 39\nyears.\nMiss\n(Alien should print or typewrite 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 Aleksander Podurgiel\nMy mother's maiden name was\nAntonina yolenkiewicz\nMy maiden name was (if woman)\nMy present occcupation is polisher - -laborer\nMy personal description is: Color, white\n; complexion, fair\n; height,\n5\nfeet 67 inches;\ndark\nweight, 160\npounds; color of hair, brown\nA\n; color of eyes,\nblue\n;\nnick I other visible andlifthingers distinctive marks: soar left Russia knuckle mow middle Poland finger Scarson on back of\nwas born in\n(City or town)\n(Country)\non the 13\nday of Sept.\n,1\n1885 7\nMy present residence is 46 Ward Str, Norwich, Conn\n(Number and street)\n(City or town)\n(County)\n(State)\nMy post office address is\nsame as above\nThe place where I took the ship or train which landed me in the United States was Hamburg, Germany\n, on Oct. 7, 1908\n(Month)\n(Day)\n(Year)\nThe ticket on which I came to this country was bought at New York, N.Y.\n(City)\n(Country)\nThe Victoria Louise,\nname of the ship or railroad on which I came was\n(OVER)\nc14-"
}