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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5238
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
I desire to file my Declaration of Intention (first paper) to become a citizen.
Mr.
My name is
Mrs.
Wladyslaw (Alien should print typewrite here true, Padewski original, and correct name)
; age,
34
years.
or
(Give age last birthday)
Miss
My present occupation is
Farmer
My personal description is: Color, white
dark
'fair
5.3/4
; complexion,
; height, 5 feet
x
inches;
weight, 135 pounds; color of hair,
brown
;
color of eyes,
brown
;
other visible distinctive marks: small left check mole on none tside of noseaut
I
was born in (City or town)
Cimiergrates
austriasion
(Country)
on the 2
day of
February
1893
Poland
My present residence is new fondon Connecticut
(Number and street)
(City or town)
(County)
(State)
The place where A took the ship or train which landed me in the United States was Bremen
Germany
on September 5 1912
(Month)
(Day)
(Year)
The name of the ship or railroad on which came was
Koln
My last place foreign (City town)
of residence was
waiblingen
Germany
or
(Country)
sacial
d
wife
Lam
married. The name of my
is
husband
maryanna
She
was born at
Hes
Cumiergyau Austria and now resides at Apbanta Connecticut
I am now a subject of and intend to renounce allegiance to
Poland
(Write name and title of sovereign and country of which now a subject;
or, if citizen of a republic, write name of republic only)
I arrived at the United States immigration port of
Baltimore
(City or town)
manyland
,
on September 21, 1912
(State or territory)
14-8
(Give exact month, day, and year)
(OVER)
Page data
- Page
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- Source index
- 0
- Type
- photo
- Media ID
- f8b15669bbb8a1a0
- 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": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5238\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\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMrs.\nWladyslaw (Alien should print typewrite here true, Padewski original, and correct name)\n; age,\n34\nyears.\nor\n(Give age last birthday)\nMiss\nMy present occupation is\nFarmer\nMy personal description is: Color, white\ndark\n'fair\n5.3/4\n; complexion,\n; height, 5 feet\nx\ninches;\nweight, 135 pounds; color of hair,\nbrown\n;\ncolor of eyes,\nbrown\n;\nother visible distinctive marks: small left check mole on none tside of noseaut\nI\nwas born in (City or town)\nCimiergrates\naustriasion\n(Country)\non the 2\nday of\nFebruary\n1893\nPoland\nMy present residence is new fondon Connecticut\n(Number and street)\n(City or town)\n(County)\n(State)\nThe place where A took the ship or train which landed me in the United States was Bremen\nGermany\non September 5 1912\n(Month)\n(Day)\n(Year)\nThe name of the ship or railroad on which came was\nKoln\nMy last place foreign (City town)\nof residence was\nwaiblingen\nGermany\nor\n(Country)\nsacial\nd\nwife\nLam\nmarried. The name of my\nis\nhusband\nmaryanna\nShe\nwas born at\nHes\nCumiergyau Austria and now resides at Apbanta Connecticut\nI am now a subject of and intend to renounce allegiance to\nPoland\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)\nI arrived at the United States immigration port of\nBaltimore\n(City or town)\nmanyland\n,\non September 21, 1912\n(State or territory)\n14-8\n(Give exact month, day, and year)\n(OVER)"
}