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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 of the shown ticket was as above
full name person on my steamship
My mother's maiden name was marie lamelie Smith
My maiden name was (if woman)
as above
My post-office address is
11 moore Court Nero London Conn.
The ticket on which I came to this country was bought at off Thomas U.S.a.v.g
(City)
(Country)
yniana
1st cabin
If arrival by ship: Name of steamship line was farmar bluebee
2d cabin
jist
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) pass port (State
which)
I paid 188
head tax at off Thomas U. & a
(State amount)
(City)
(State or country)
, on g
(Month)
(Day)
(Year)
I was examined by immigration officers at
on steamer at N. y.
At that time I intended to remain (permanently, temporarily, for visit, in transit)
temporarily
(State which)
The person in the United States I was coming to was am Brunett
(Give name in full)
The place in the United States I was going to was New London comm.
The names of some of the persons or passengers I traveled with were miss Louise gumbs
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
Mexico
(c) On
(Month)
(Day)
(Year)
(d) The place where I was examined for admission at the United States border was
(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
GOVERNMENT PRENTING OFFICE 14-
8
(OVER)
Eulalie (Signature of Blodge applicant)
Page data
- Page
- 866
- Source index
- 0
- Type
- photo
- Media ID
- 5c23776fb1bac7c9
- 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 of the shown ticket was as above\nfull name person on my steamship\nMy mother's maiden name was marie lamelie Smith\nMy maiden name was (if woman)\nas above\nMy post-office address is\n11 moore Court Nero London Conn.\nThe ticket on which I came to this country was bought at off Thomas U.S.a.v.g\n(City)\n(Country)\nyniana\n1st cabin\nIf arrival by ship: Name of steamship line was farmar bluebee\n2d cabin\njist\n3d cabin\nI arrived as (passenger, stowaway, seaman, member of crew, or otherwise)\nPassenger\nState which)\nI\ntraveled on (an immigration visa, a passport, a permit) pass port (State\nwhich)\nI paid 188\nhead tax at off Thomas U. & a\n(State amount)\n(City)\n(State or country)\n, on g\n(Month)\n(Day)\n(Year)\nI was examined by immigration officers at\non steamer at N. y.\nAt that time I intended to remain (permanently, temporarily, for visit, in transit)\ntemporarily\n(State which)\nThe person in the United States I was coming to was am Brunett\n(Give name in full)\nThe place in the United States I was going to was New London comm.\nThe names of some of the persons or passengers I traveled with were miss Louise gumbs\nADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME FROM OR THROUGH CANADA OR MEXICO:\n(a) The place in Canada where I landed was\n, on\n(Month)\n(Day)\n(Year)\n{\nCanada\n(b) The place in\nfrom which I entered the United States was\nMexico\n(c) On\n(Month)\n(Day)\n(Year)\n(d) The place where I was examined for admission at the United States border was\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\nGOVERNMENT PRENTING OFFICE 14-\n8\n(OVER)\nEulalie (Signature of Blodge applicant)"
}