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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5555
5233
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
I desire to file my Declaration of Intention (first paper) to become a citizen.
Mr.
My name is
Mrs.
/
Meryon Poplauski
; age, 18 Death years.
(Alien should ufint or typewrite here/true, original, and Correct name)
(Give age last birthday)
My
My personal description is: Color, white ; complexion, dark
present occupation Miss is work the farm labover
; height, 5
feet
8
71/4
inches;
weight, 150 pounds; color of hair, burnettebrown ; color of eyes, brown
;
other visible distinctive marks: none
I was
born in Ratowo Stare, Russia, nongland
(Qity or town)
(Country)
My on the residence 14 is day 909
of
present
(Number and street)
(City or town)
(County)
(State)
The or me was
place where I took the ship train which landed in the United States Johohama,
Jahan
, on
October 13, 19/7
The the ship railroad which I was Fushims (Month) maru
(Day)
(Year)
name of or on came
My last place of foreign residence
sard was Stare Katown
Poland
(City or town)
(Country)
I am no married. The name of my { wife husband
She
is
}
was born at
He
, and now resides at
,
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,
I arrived at port
if citizen of a the republic, United write name States of republic immigration only) of Seattle
(City or town)
Washington
(State or territory)
, on nov.5,1917 14-8
(Give exact month, day, and year)
(OVER)
Page data
- Page
- 921
- Source index
- 0
- Type
- photo
- Media ID
- 41bda3f72ea053ec
- 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\n5555\n5233\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\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMrs.\n/\nMeryon Poplauski\n; age, 18 Death years.\n(Alien should ufint or typewrite here/true, original, and Correct name)\n(Give age last birthday)\nMy\nMy personal description is: Color, white ; complexion, dark\npresent occupation Miss is work the farm labover\n; height, 5\nfeet\n8\n71/4\ninches;\nweight, 150 pounds; color of hair, burnettebrown ; color of eyes, brown\n;\nother visible distinctive marks: none\nI was\nborn in Ratowo Stare, Russia, nongland\n(Qity or town)\n(Country)\nMy on the residence 14 is day 909\nof\npresent\n(Number and street)\n(City or town)\n(County)\n(State)\nThe or me was\nplace where I took the ship train which landed in the United States Johohama,\nJahan\n, on\nOctober 13, 19/7\nThe the ship railroad which I was Fushims (Month) maru\n(Day)\n(Year)\nname of or on came\nMy last place of foreign residence\nsard was Stare Katown\nPoland\n(City or town)\n(Country)\nI am no married. The name of my { wife husband\nShe\nis\n}\nwas born at\nHe\n, and now resides at\n,\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,\nI arrived at port\nif citizen of a the republic, United write name States of republic immigration only) of Seattle\n(City or town)\nWashington\n(State or territory)\n, on nov.5,1917 14-8\n(Give exact month, day, and year)\n(OVER)"
}