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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5049
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
upper left-hand corner of all copies of
CARD INDEX
declaration, immediately under your
INDEX BOOKS
declaration number.
DISTRICT DIRECTOR OF NATURALIZATION
MANIFESTS
I desire to file my Declaration of Intention (first paper) to become a citizen.
Mr.
My name is
Mrs>
ARMAND LEFEBVARE
; age,
203
years.
Miss
(Alien should print or typewrite here true, original, and correct name)
(Give age last birthday)
My present occupation is
Clerk
My personal description is: Color, while ; complexion, farlight ; height, 5 feet 7/1/2 inches;
weight, 142 pounds; color of hair, light nown color of eyes, thing
;
other visible
distinctive marks: unn
I was
born in (City or town) thorince af (Country) Camade
Rafhaill
on the 22 day of august
1903
Praft
My
present avenue, residence is (Number and street) norwich (City town) N.L. (County) Corn (State)
Tafkinle
or
The place where I took the ship or train which landed me in the United States was
Montinal
Canada
on Jan (Month) 13.
1904
The name of the ship railroad which I was Central (Day) (Year)
or on came
My last place of foreign
residence said was It (City town) Conte (Country) Bellikan
Rophael
or
marianna
I am nes married. The name of my
{
wife
}
She
is
was born at
husband
H.
, and now resides at
I am now a subject of and intend to renounce allegiance to
(Write and title of sovereign and country of which subject;
name now a
or, if citizen of a republic, write name of republic only)
I arrived at the United States immigration port
of At allanso aft
(City or town)
, on Jan 14-8 15,1904. (Give exact month, day, and year)
(State or territory)
(OVER)
Page data
- Page
- 351
- Source index
- 0
- Type
- photo
- Media ID
- 556278e3da90de5a
- 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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Document source extras
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Page context
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"ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5049\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\nupper left-hand corner of all copies of\nCARD INDEX\ndeclaration, immediately under your\nINDEX BOOKS\ndeclaration number.\nDISTRICT DIRECTOR OF NATURALIZATION\nMANIFESTS\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMrs>\nARMAND LEFEBVARE\n; age,\n203\nyears.\nMiss\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nMy present occupation is\nClerk\nMy personal description is: Color, while ; complexion, farlight ; height, 5 feet 7/1/2 inches;\nweight, 142 pounds; color of hair, light nown color of eyes, thing\n;\nother visible\ndistinctive marks: unn\nI was\nborn in (City or town) thorince af (Country) Camade\nRafhaill\non the 22 day of august\n1903\nPraft\nMy\npresent avenue, residence is (Number and street) norwich (City town) N.L. (County) Corn (State)\nTafkinle\nor\nThe place where I took the ship or train which landed me in the United States was\nMontinal\nCanada\non Jan (Month) 13.\n1904\nThe name of the ship railroad which I was Central (Day) (Year)\nor on came\nMy last place of foreign\nresidence said was It (City town) Conte (Country) Bellikan\nRophael\nor\nmarianna\nI am nes married. The name of my\n{\nwife\n}\nShe\nis\nwas born at\nhusband\nH.\n, and now resides at\nI am now a subject of and intend to renounce allegiance to\n(Write and title of sovereign and country of which subject;\nname now a\nor, if citizen of a republic, write name of republic only)\nI arrived at the United States immigration port\nof At allanso aft\n(City or town)\n, on Jan 14-8 15,1904. (Give exact month, day, and year)\n(State or territory)\n(OVER)"
}