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Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 5343 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 46563 Place number in CARD INDEX NATORALIZATION SERVIOR upper left-hand corner of all copies of thinking declaration, immediately under your INDEX BOOKS declaration number. MAY 7 DISTRICT DIRECTOR OF NATURALIZATION MANIFESTS SERVICE LAROR MAY 5 1928 I desire to file my Declaration of Intention (first paper) to become a citizen. Mr. My name is Mra. Antoni OFFICE QF BX ANN, ; Fedoprazia age, 2830 years. Miss (Alien should print or typewrite here true, original, and My present occupation is labores LABOR (Give age last birthday) My personal weight, 150 description pounds; is: Color, color white: of hair, blond complexion, lightfair light ; color of ; height, b 5 lue feet H 53/4 5 inches; eyes, ; other visible distinctive marks: none I was born in mta w as ,Russia,now Poland 3028 (City Gevember or town) (Country) Road The e if on the day of dyngast , 887 My present residence is 388 St, Norwich Conn A (Number and street) (City or town) (County) (State) The place where I took the ship or train which landed me in the United States was Danging December-3-1926 gdonsk , on The name of the ship or railroad on which I came was Lithuaniateania (Month) (Day) (Year) My last place of foreign residence was Strygowk, (City or town) Poland (Country) I am yes married. The name of my { wife is Genowafa Fedorogy He She was born at husband I am now a subject of and intend to renounce allegiance to Republic (Write and title of sovereign of and Poland country of which unizy 52, Poland and now resides at Ry szyn Poland name now a subject; if citizen of a write name of I or, arrived at the republic, United States republic immigration only) port of New york (City town) n.4 , on 20, 1926 December or , (State or territory) 14-8 (Give exact month, day, and year) leaker up (OVER) of A ISSUED AV 17 1928

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Document data

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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5343\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\n46563\nPlace number\nin\nCARD INDEX\nNATORALIZATION SERVIOR\nupper left-hand corner of all copies of\nthinking\ndeclaration, immediately under your\nINDEX BOOKS\ndeclaration number.\nMAY\n7\nDISTRICT DIRECTOR OF NATURALIZATION\nMANIFESTS\nSERVICE\nLAROR\nMAY 5 1928\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMra.\nAntoni OFFICE QF BX ANN, ;\nFedoprazia\nage,\n2830 years.\nMiss\n(Alien should print or typewrite here true, original, and\nMy present\noccupation is labores\nLABOR\n(Give age last birthday)\nMy personal weight, 150 description pounds; is: Color, color white: of hair, blond complexion, lightfair light ; color of ; height, b 5 lue feet\nH 53/4\n5\ninches;\neyes,\n;\nother visible distinctive marks:\nnone\nI was born in\nmta w as ,Russia,now Poland\n3028\n(City Gevember or town)\n(Country)\nRoad The e if\non the day of\ndyngast\n,\n887\nMy present residence is 388 St, Norwich Conn\nA\n(Number and street)\n(City or town)\n(County)\n(State)\nThe place where I took the ship or train which landed me in the United States was\nDanging\nDecember-3-1926\ngdonsk\n, on\nThe name of the ship or railroad on which I came was Lithuaniateania (Month) (Day) (Year)\nMy last place of foreign residence was\nStrygowk,\n(City or town) Poland (Country)\nI\nam yes married. The name of my { wife\nis\nGenowafa Fedorogy He She\nwas born at\nhusband\nI\nam now a subject of and intend to renounce allegiance to Republic (Write and title of sovereign of and Poland country of which\nunizy 52, Poland and now resides at Ry szyn Poland\nname now a subject;\nif citizen of a write name of\nI or, arrived at the republic, United States republic immigration only) port of New york (City town) n.4\n, on 20, 1926\nDecember\nor\n,\n(State or territory)\n14-8\n(Give exact month, day, and year)\nleaker\nup\n(OVER)\nof A ISSUED\nAV 17 1928"
}