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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 4905 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. Sanuel Schaeller # 42 ; age, years. Miss (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 maiden name was My maiden name was (if woman) My present occcupation is Painter My personal description is: Color, White fan ; height, 5 feet 2 1/2 inches; ; complexion, weight, 135 pounds; Dark color of hair, Brown ; color of eyes, Brown ; other visible distinctive marks: none I was born in Vitepok (City Russia towp) or (Country) on the 24 day of Lebanon n L. Comm September 884 My present residence is My post office address is (Number and Prun R7WH The place where I took the ship or train which landed in the United States was Hunburg. gantee, street (City or town) (County) / (State) me Jerwany , on July (Month) 23, 1910 (Day) (Year) The ticket on which I eame to this country was bought at The of the ship railroad which I Kaiserim '(City) Augusta Victoria Country) name or on came was (OVER) c14-8

Page data

Page
64
Source index
0
Type
photo
Media ID
d7b61eae912359c3
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\n4905\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\nstatements\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.\nSanuel Schaeller\n# 42\n; age,\nyears.\nMiss\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 maiden name was\nMy maiden name was (if woman)\nMy present occcupation is Painter\nMy personal description is: Color, White fan ; height, 5 feet 2 1/2 inches;\n; complexion,\nweight, 135 pounds; Dark color of hair, Brown\n;\ncolor of eyes, Brown\n;\nother visible distinctive marks:\nnone\nI\nwas born in Vitepok (City Russia towp)\nor\n(Country)\non the\n24 day of Lebanon n L. Comm\nSeptember\n884\nMy present residence is\nMy post office address is (Number and Prun R7WH\nThe place where I took the ship or train which landed in the United States was Hunburg.\ngantee,\nstreet (City or town) (County) /\n(State)\nme\nJerwany\n, on July (Month)\n23, 1910\n(Day)\n(Year)\nThe ticket on which I eame to this country was bought at\nThe of the ship railroad which I Kaiserim '(City) Augusta Victoria Country)\nname or on came was\n(OVER)\nc14-8"
}