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{
    "localId": "159596813",
    "label": "File numbers 4874 - 5509, 1926-1930",
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    "contentType": "document",
    "title": "File numbers 4874 - 5509, 1926-1930",
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    "collections": [
        "Naturalization Records of Non-Federal Courts in Connecticut",
        "Applications for Declaration of Intention"
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{
    "seq": 42,
    "pageIndex": 0,
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    "ocrText": "6820\nSM.\nHATUY RALIZATION SERVICE\nForm 2213\nRECEIVED\nFACTS FOR DECLARATION OF INTENTION\nGlark of Conte:\nPiace nymber\n20397\nin upgor comer\n/ATURALIZATION suaviché AY 5 1926\nof all cost declaration jemediately under\nRECEIVED\nyour\ndeclarazluna number U. S. DEPARTMENT OF LABOR\nOFFICE OF EXAMINER\nDietrict\nNATURALIZATION SERVICE\nMAY 27 1926 Det NEW 'ARTMENT HAVEN, OF CONN. LABOR,\n4894\nCALTIFICATE UH\nARLIVAL DIVISION\nH'GLIS ISLAND, N\nY\nNOTE.- A copy of this form will bo furnished by the clerk of the courthithe hieiNaturalization Examiner, or the\npublic=school teacher to each applicant for a declaration of intention, so that ho can at his leisure fill in the answers to\nthe questions. After being filled out the applicant should take the form to the offico of the clerk of court to be used\nby him in properly filling out the doclaration. Care should bo used to state as near as can be remembered the day,\nmonth, and year of arrival, as well as the name of the vessel on which the alien emigrated to this country.\nTO THE APPLICANT.-The fee of one dollar required by law for the declaration, must be paid to the clert of the\ncourt before he commences to fill out the declaration of intention. No fee is chargeable for this blank, and none\nshould be paid for assistance in filling it out, as the Naturalization Examiner or the public-school teacher will help you\nfreo of charge.\nConstantive\nMy name is\nDemosthenes (Alien should state here his true, Pi original, Chryssorruggis and correct name in full.) Age:\n(Give age at last birthday\neq/23\nyears.\nAlso as Demostheness Chrissas\nimmediately above\nOccupation:\nColor:\nwhite\nPoultry (If allen has, used any other former name in this country that name should be shown on line\nComplexion:\nHeight:\nfirst feet force 4 inches. Weight: 134\npounds.\nColor of\nhair: dark brown black brown\nColor of eyes:\nOther visible distinctive marks:\nnone\n(IIno visible distinctive marks, so state.)\nWhhere born:\nIsland Samos Green\n(City or town.)\n(Country.)\nDate of birth:\nSeptember\n1903\n(Month.)\n(Day.\n(Year.)\nPresent residence:\nGrove Cive\nGeroton Conn\n(Number and street.)\n(State, Territory, or District.)\nConstantinable\n(City or town.)\nEmigrated from:\n(Place where alien got on ship or train to come to the United States.)\nTurkey\n(Country.)\nName of vessel:\n(If the arrived otherwi than by vessel, character conveyance or name of transportation company should be given.)\nalien King alexander the of\nLast place of foreign residence:\nSaled (City town.) Suching (Country.)\nConstantionally\nor\n*I am not married; of my swife\nthusband)\nis\ntohal The was\n*born at\n; and now resides at\nI am now a subject of and intend to renounce allegiance to Usfangia\n(Write name and title of sovereign country now a or II write name of\nGreen and of which the subject; Greek citizen of a/Republic, Republic RepubHconly.)\nI arrived at the port of\non or about\njuly (Month.) 2nd qut (Day\nBrooklyn (City or town. new yours (State Territory.)\nnew York\nor\n,\n(Year.)\nwas detained\nat Ellio NOTE TO Island CLERK OF COURT.- 24days two limes indicated because by the * contain quota information which had is provided been for by exseeded. blanks on the\nlatest\ndeclaration of intention form; until such time as you may be supplied with forms containing these blank spaces the information called\nfor herein should be inserted immediately ABOVE the twelfth line, which begins \" It is my bona fide intention,\" etc., as requested\nin\ncircular letter of January 5, 1916.\nGOVERNMENT PRINTING OFFICE\nDemositimes address Chrissos Box5, Grotow, of"
}