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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5719
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.
tm guiseppe messina
; age, 22
years.
Miss
(Alien Should print or typewrite here true, original, and correct name)
(Give age last birthday)
Also known as Josephus (If alien messina has used any other
name in this country, that name should be shown here)
I used that name because of Pronunciation
The full name of the person shown on my steamship ticket was guiseppe messina
My mother's maiden name was Francesca De maggio
My maiden name was (if woman)
My present occcupation is Electricion dark
41/2
My personal description is: Color, White ; complexion, light
; height, 5 inches;
weight, 140 pounds; color darbrown of hair,
other visible distinctive marks: ; andivered eyes,
color of
I was born in Jusa (City town)
Italay
or
(Country)
on the 13
day of
December
1904
My present residence is 50 montauk (Number and street) Give. (City town) new fondan (County) Conn. (State)
or
My post office address is
The where I took the train which landed in the United States was
place ship Palermo Italy
or me
,
on sept. (Month) 7 -1910 (Day),
(Year)
The ticket on which I came to this country was bought at
Italy
(Country)
The name of the ship or reilread on which I came was Luisiana
(Cit
(OVER)
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"ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5719\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.\ntm guiseppe messina\n; age, 22\nyears.\nMiss\n(Alien Should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nAlso known as Josephus (If alien messina has used any other\nname in this country, that name should be shown here)\nI used that name because of Pronunciation\nThe full name of the person shown on my steamship ticket was guiseppe messina\nMy mother's maiden name was Francesca De maggio\nMy maiden name was (if woman)\nMy present occcupation is Electricion dark\n41/2\nMy personal description is: Color, White ; complexion, light\n; height, 5 inches;\nweight, 140 pounds; color darbrown of hair,\nother visible distinctive marks: ; andivered eyes,\ncolor of\nI was born in Jusa (City town)\nItalay\nor\n(Country)\non the 13\nday of\nDecember\n1904\nMy present residence is 50 montauk (Number and street) Give. (City town) new fondan (County) Conn. (State)\nor\nMy post office address is\nThe where I took the train which landed in the United States was\nplace ship Palermo Italy\nor me\n,\non sept. (Month) 7 -1910 (Day),\n(Year)\nThe ticket on which I came to this country was bought at\nItaly\n(Country)\nThe name of the ship or reilread on which I came was Luisiana\n(Cit\n(OVER)"
}