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Form 2213 20-77-7774 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 5308 U. S. DEPARTMENT OF LABOR NOT TO BE FILLED IN BY ALIEN FOR USE OF OFFICIALS SEARCHING IMMI- IATURALIZATION SERVICE GRATION RECORDS CLERK OF COURT: NATURALIZATION SERVICE RECORDS EXAMINED 21752 JUL 20 1926 RECEIVED Place number in CARD INDEX DIRECTOR MASSJUL upper left-hand corner of all copies of 19 1926 declaration, immediately under your INDEX BOOKS DEPARTMENT BOSTON, OF OFFICE LABORAT OF declaration number. EXAMINER NEW HAVEN, CONN. DISTRICT DIRECTOR OF NATURALIZATION. MANIFESTS DEPARTMENT OF LABOR (NOTE TO CLERK OF COURT.-T 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.) NATURALIRATION SERVICE I desire to file my Declaration of Intention (first paper) to become a Mr. Othicsion My name is Mrs. Levis. Otson AU;Gage, 8 122 24 years. Migs (Alien should print or typewrite here true, original, and correct name) (Give age last birthday) CERTIFICATE OF Also known as JOCL Levis OLAUSSON ARRIVAL DIVITION (If alien has used any other name in this country, that namo should bo-shown hore) Y. it was my fathers name DEPARTMENT OF LABOR. I used that name because The full name of the person shown on my steamship ticket was Jack Levis. OLSON My mother's maiden Eva Kelberg name was My maiden name was (if woman) Eva Olanson, Hael hewis My present occcupation is weaver My personal description is: Color, White ; complexion, white an ; height, 5 feet 9 inches; weight, 145 pounds; color of Cendre brow ; of hair, color eyes, blue ; other visible distinctive marks: none olebackright Ear and I born in Lerum was Tweden (City or town) (Country) on the 8 day of april 1904 ravery My residence is Windham Cann present Box 27, is Knin (Number and street) (City or town) (County) (State) My post office address Plainsfield. Come The place where I took the ship or train which landed me in the United States was Sothenburg Lurden , on October 13 1923 (Month) (Day) (Year) The ticket on which I came to this country was bought at new (Qit) York U.S.A. (Country) The name of the ship or railroad on which I came was Distringhall (OVER) 10/23/23

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    "ocrText": "Form 2213\n20-77-7774\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5308\nU. S. DEPARTMENT OF LABOR\nNOT TO BE FILLED IN BY ALIEN\nFOR USE OF OFFICIALS SEARCHING IMMI-\nIATURALIZATION SERVICE\nGRATION RECORDS\nCLERK OF COURT:\nNATURALIZATION SERVICE\nRECORDS EXAMINED\n21752\nJUL 20 1926\nRECEIVED\nPlace number\nin\nCARD INDEX\nDIRECTOR MASSJUL\nupper left-hand corner of all copies of\n19\n1926\ndeclaration, immediately under your\nINDEX BOOKS\nDEPARTMENT BOSTON, OF OFFICE LABORAT OF\ndeclaration number.\nEXAMINER\nNEW HAVEN, CONN.\nDISTRICT DIRECTOR OF NATURALIZATION.\nMANIFESTS\nDEPARTMENT OF LABOR\n(NOTE TO CLERK OF COURT.-T 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.)\nNATURALIRATION SERVICE\nI desire to file my Declaration of Intention (first paper) to become a\nMr.\nOthicsion\nMy name is\nMrs.\nLevis. Otson AU;Gage, 8 122 24 years.\nMigs\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nCERTIFICATE OF\nAlso known as\nJOCL Levis OLAUSSON ARRIVAL\nDIVITION\n(If alien has used any other name in this country, that namo should bo-shown hore) Y.\nit was my fathers name\nDEPARTMENT OF LABOR.\nI used that name because\nThe full name of the person shown on my steamship ticket was Jack Levis. OLSON\nMy mother's maiden Eva Kelberg\nname was\nMy maiden name was (if woman) Eva Olanson, Hael hewis\nMy present occcupation is weaver\nMy personal description is: Color, White ; complexion, white an ; height, 5\nfeet 9 inches;\nweight,\n145 pounds; color of Cendre brow ; of\nhair,\ncolor eyes,\nblue\n;\nother visible distinctive marks:\nnone olebackright Ear and\nI born in Lerum\nwas\nTweden\n(City or town)\n(Country)\non the\n8\nday of\napril\n1904\nravery My residence is Windham Cann\npresent\nBox 27, is Knin\n(Number and street)\n(City or town)\n(County)\n(State)\nMy post office address\nPlainsfield. Come\nThe place where I took the ship or train which landed me in the United States was Sothenburg\nLurden\n, on\nOctober\n13\n1923\n(Month)\n(Day)\n(Year)\nThe ticket on which I came to this country was bought at new (Qit) York\nU.S.A.\n(Country)\nThe name of the ship or railroad on which I came was\nDistringhall\n(OVER)\n10/23/23"
}