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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 4904 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. allen My name is Samuel Pearson ; age, 24 years. (Alien should print or typewrite here true, original, and correct name) (Give age last birthday) Also known as (If alien has used any other name in this country, that name should be shown here) I used that name because The full name of the person shown on my steamship ticket was My mother s maidon name wasy My maider name was (if woman) My present occcupation is salesman 9 My personal description is: Color, white ; complexion, fair 5 10 ; height, feet inches; weight, 165 pounds; color of hair, brown blue ; color of eyes, other visible distinctive Vilna marks: Scar on Russia I was born in left forefinges (City or town) (Country) on the 20th day of May 1 902 My present residence is Bozrah (Number Street-- and street) (City New , Bograhi London Conn. or town) (County) (State) My post office address is Yantic, Conn. R.F.D. # 1 The place where I took the ship or train which landed me in the United States was Liverpool, England , on December 15, 1905 (Month) (Day) (Year) The ticket on which I camo to this country was bought at (City) (Country) The name of the ship or railroad on which I came was (OVER) 014-8

Page data

Page
62
Source index
0
Type
photo
Media ID
e282d2ab453780ef
Size
unknown

Document data

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

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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n4904\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.\nallen\nMy name is\nSamuel Pearson\n; age,\n24\nyears.\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nAlso known as\n(If alien has used any other name in this country, that name should be shown here)\nI used that name because\nThe full name of the person shown on my steamship ticket was\nMy mother s maidon name wasy\nMy maider name was (if woman)\nMy present occcupation is\nsalesman\n9\nMy personal description is: Color, white ; complexion, fair\n5\n10\n; height,\nfeet\ninches;\nweight, 165\npounds; color of hair,\nbrown\nblue\n; color of eyes,\nother\nvisible distinctive Vilna marks: Scar on Russia\nI was born in\nleft forefinges\n(City or town)\n(Country)\non the\n20th\nday of\nMay\n1 902\nMy present\nresidence is Bozrah (Number Street-- and street) (City New ,\nBograhi\nLondon\nConn.\nor town)\n(County)\n(State)\nMy post office address is\nYantic, Conn. R.F.D. # 1\nThe place where I took the ship or train which landed me in the United States was Liverpool,\nEngland\n, on\nDecember\n15,\n1905\n(Month)\n(Day)\n(Year)\nThe ticket on which I camo to this country was bought at\n(City) (Country)\nThe name of the ship or railroad on which I came was\n(OVER)\n014-8"
}