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I have not used another name in this country than that given at the beginning of this form. If so, it was I used that name because The full name of the person shown on my steamship ticket was My mother's maiden name was margaret majver My maiden name was (if woman) anna of Blue My post-office address is Horwich state Hospital The ticket on which I came to this country was bought at RiverDennis Station Nova Scotia (City) (Country) 1st cabin If arrival by ship: Name of steamship line was 2d cabin 3d cabin I arrived as (passenger, stowaway, seaman, member of crew, or otherwise) Passenger (State which) I traveled on (an immigration visa, a passport, a permit) Permit (State which) I paid $8.00 head tax at St. Johns n. B. Canadaon October 18 1917 (State amount) (City) (State or country) (Month) (Day) (Year) I was examined by immigration officers at St John's n. B. At that time I intended to remain (permanently, temporarily, for visit, in transit) Temporarily (State which) The person coming in the United States I was to was Mrs. Jessie Foster (Give name in full) The place in the United States I was going to was Boston mass. The names of some of the persons or passengers I traveled with were ADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME FROM OR THROUGH CANADA OR MEXICO: (a) The place in Canada where I landed was on (Month) (Day) (Year) { Canada (b) The place in from which I entered the United States was st. Johns n. B. Mexico (c) On October 18 1917 (Month) (Day) (Year) (d) The place where I was examined for admission at the United States border was St John's new Brunswick (e) If not examined, state why, and give the circumstances of your entry Canada (f) The place in Mexico where I bought my railroad ticket to come to the United States was River Denni is Station miss anna Blue Certrude GOVERNMENT PRINTING OFFICE (OVER) (Signature of applicant)

Page data

Page
644
Source index
0
Type
photo
Media ID
44e79f86108ee1a2
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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Document source extras
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Page context
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    "ocrText": "I have not used another name in this country than that given at the beginning of this form. If so, it was\nI used that name because\nThe full name of the person shown on my steamship ticket was\nMy mother's maiden name was\nmargaret majver\nMy maiden name was (if woman)\nanna of Blue\nMy post-office address is\nHorwich state Hospital\nThe\nticket\non\nwhich\nI\ncame\nto\nthis\ncountry\nwas\nbought\nat\nRiverDennis\nStation\nNova\nScotia\n(City)\n(Country)\n1st cabin\nIf arrival by ship: Name of steamship line was\n2d cabin\n3d cabin\nI\narrived as (passenger, stowaway, seaman, member of crew, or otherwise) Passenger\n(State which)\nI traveled on (an immigration visa, a passport, a permit)\nPermit\n(State which)\nI paid $8.00 head tax at\nSt. Johns n. B. Canadaon October 18 1917\n(State amount)\n(City)\n(State or country)\n(Month)\n(Day)\n(Year)\nI was examined by immigration officers at\nSt John's n. B.\nAt that time I intended to remain (permanently, temporarily, for visit, in transit)\nTemporarily\n(State which)\nThe person coming\nin the United States I was to was Mrs. Jessie Foster\n(Give name in full)\nThe place in the United States I was going to was\nBoston mass.\nThe names of some of the persons or passengers I traveled with were\nADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME FROM OR THROUGH CANADA OR MEXICO:\n(a) The place in Canada where I landed was\non\n(Month)\n(Day)\n(Year)\n{\nCanada\n(b) The place in\nfrom which I entered the United States was st. Johns n. B.\nMexico\n(c) On\nOctober\n18\n1917\n(Month)\n(Day)\n(Year)\n(d) The place where I was examined for admission at the United States border was\nSt John's new Brunswick\n(e) If not examined, state why, and give the circumstances of your entry\nCanada\n(f) The place in\nMexico\nwhere I bought my railroad ticket to come to the United States was\nRiver Denni is Station\nmiss anna Blue\nCertrude\nGOVERNMENT PRINTING OFFICE\n(OVER)\n(Signature of applicant)"
}