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File numbers 4874 - 5509, 1926-1930

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Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 5077 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 I desire to file my Declaration of Intention (first paper) to become a citizen. Mr. My name is Mrs. Wladys/AW Klimaszewski ; age, 38 years. Miss (Alién should print or typewrite here true, original, and correct name) (Give age last birthday) My present occupation is Weaver My personal description is: Color, White complexion, Dark ; height, 5 feet 4% inches; weight, 150 pounds; color of hair, brown ; color of eyes, brown ; other visible distinctive marks: scar on Left Knuckles mou on left cheekand I was born in Krawcliski) Russia, now Lithuania (City or town) (Country) on the 17th day of Decem ber ,1 878 , My present residence is 13 Sherman St. nerwich Connecticut (Number and street) (City or town) (County) (State) The place where I took the ship or train which landed me in the United States was Bremen Germany. on December JFS 1910 , (Month) (Day) (Year) The name of the ship or railroad on which I came was Branden burg My last place of foreign residence was Szokni RUMBER Lithnania (City or town) (Country) wife I am married. The name of my husband } is Helena She was born at He Troki Paland , and now resides said at 13 Sherman St I am now a subject of and intend to renounce allegiance to Lithuania (Write name and title of sovereign and country of which now a subject; or, if citizen of a republic, write name of republic only) I arrived at the United States immigration port of New York (City or town) , on Decem ber 26th 1910 (State or territory) 14-8 (Give exact month, day, and year) (OVER)

Page data

Page
406
Source index
0
Type
photo
Media ID
511e170590afa211
Size
unknown

Document data

ID
159596813
Core
doc
Type
document
DTO data 
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Context sent to Scholar

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Page context 
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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5077\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\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMrs.\nWladys/AW Klimaszewski\n; age,\n38\nyears.\nMiss\n(Alién should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nMy present occupation\nis Weaver\nMy personal description is: Color, White\ncomplexion, Dark\n; height, 5\nfeet 4% inches;\nweight, 150\npounds; color of hair, brown\n; color of eyes, brown\n;\nother visible distinctive marks: scar on Left Knuckles\nmou on left cheekand\nI was born in\nKrawcliski) Russia, now\nLithuania\n(City or town)\n(Country)\non the\n17th day of Decem ber\n,1 878\n,\nMy present residence is\n13 Sherman St.\nnerwich Connecticut\n(Number and street)\n(City or town)\n(County)\n(State)\nThe place where\nI took the ship or train which landed me in the United States was Bremen Germany.\non December JFS\n1910\n,\n(Month)\n(Day)\n(Year)\nThe name of the ship or railroad on which I came was\nBranden burg\nMy last place of foreign residence was Szokni\nRUMBER\nLithnania\n(City or town)\n(Country)\nwife\nI am\nmarried. The name of my\nhusband\n}\nis\nHelena\nShe\nwas born at\nHe\nTroki Paland\n, and now resides\nsaid at 13 Sherman St\nI am now a subject of and intend to renounce allegiance\nto\nLithuania\n(Write name and title of sovereign and country of which now a subject;\nor, if citizen of a republic, write name of republic only)\nI arrived at the United States immigration port of\nNew York\n(City or town)\n,\non Decem ber 26th 1910\n(State or territory)\n14-8\n(Give exact month, day, and year)\n(OVER)"
}