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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5183
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
Jadeusg Stadnicki
I desire to file my Declaration of Intention (first paper) to become a citizen.
Mr.
My name is
Mrs.
Tadeun Stadnicki
;
(Allen should print or typewrite here true, original, and correct name)
age, off 34
years.
Miss
Give age last birthday)
My present occupation is Laborts
My personal description White complexion, fair
is: Color, ;
; height, 5
feet 2 3/4 inches;
weight, 120
pounds;
light color in hait. Brown
visible distinctive marks: Scara and of right little finger
; color of eyes, Gray
;
other
I was born in
Hupide, austria would boland (Country)
City or town)
on the 5
day of
st. December Grishword 1892
P.O. Box. 102
My present residence is 3 Hig (Number h jewett and street) (City or town) London (County) Conn
City Gevt
(State)
The
place where I took the ship or train which landed me in the United States was H amburg
Hermany
on Feb
12
,
1909
(Month)
(Day)
(Year)
The name of the ship or railroad on which Icame was H amburg
My
last place of foreign said residence was
Stupies
Valand
(City or town)
I am
married. The name of my
{
wife
is anna Stanlmaha
(Country)
She
was born at
Karwand
husband
Ilc
,
, and
now
said resides at, 3 Hight Finett City
I am now a subject of and intend to renounce allegiance to
(Write name and title of sovereign and country of which now a subject;
or, if citizen of a republic, write name of republic only)
Republic of Poland
I arrived at the United States immigration port of new York
ny
on (City town) 1909
march
or
,
(State or territory)
14-8
(Give exact month, day, and year)
(OVER)
Page data
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- Source index
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- Type
- photo
- Media ID
- f536c36bb6e257f9
- 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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"ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5183\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\nJadeusg Stadnicki\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMrs.\nTadeun Stadnicki\n;\n(Allen should print or typewrite here true, original, and correct name)\nage, off 34\nyears.\nMiss\nGive age last birthday)\nMy present occupation is Laborts\nMy personal description White complexion, fair\nis: Color, ;\n; height, 5\nfeet 2 3/4 inches;\nweight, 120\npounds;\nlight color in hait. Brown\nvisible distinctive marks: Scara and of right little finger\n; color of eyes, Gray\n;\nother\nI was born in\nHupide, austria would boland (Country)\nCity or town)\non the 5\nday of\nst. December Grishword 1892\nP.O. Box. 102\nMy present residence is 3 Hig (Number h jewett and street) (City or town) London (County) Conn\nCity Gevt\n(State)\nThe\nplace where I took the ship or train which landed me in the United States was H amburg\nHermany\non Feb\n12\n,\n1909\n(Month)\n(Day)\n(Year)\nThe name of the ship or railroad on which Icame was H amburg\nMy\nlast place of foreign said residence was\nStupies\nValand\n(City or town)\nI am\nmarried. The name of my\n{\nwife\nis anna Stanlmaha\n(Country)\nShe\nwas born at\nKarwand\nhusband\nIlc\n,\n, and\nnow\nsaid resides at, 3 Hight Finett City\nI am now a subject of and intend to renounce allegiance to\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)\nRepublic of Poland\nI arrived at the United States immigration port of new York\nny\non (City town) 1909\nmarch\nor\n,\n(State or territory)\n14-8\n(Give exact month, day, and year)\n(OVER)"
}