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I have never used another name in this country than that given at the beginning of this form. If so, it was I used that name because X The full name of the person shown on my steamship ticket was Knut Emprood Samuelsou My mother's maiden name was Anna X Tarabarg My maiden name was (if woman) My post-office address is P.O. Box 27 - myster -form Fature - - Sweden The ticket on which I came to this country was bought at (City) (Country) If arrival by ship: Name of steamship line was Smedish american lat cabin 2d cabin 3d cabin 3rd less I arrived as (passenger, stowaway, seaman, member of crew, or otherwise) (State which) Passenger I traveled on (an immigration visa, a passport, a permit) Passport (State which) I paid 30KR (State amount) head tax at (City) (State country) on august (Month) (Day) 27Th-1926 (Year) or I was examined by immigration officers at my At that time I intended to remain (permanently, temporarily, for visit, in transit) (State which) The person in the United States I was coming to was Richard Jedor permanently Samuelson The place in the United States I was going to was Providence - R.I (Give name in full) The names of some of the persons or passengers I traveled with were Arthur Sand 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 PRINTING OFFICE 14- (OVER) Knot Erford (Signature of applicant) danue lson

Page data

Page
944
Source index
0
Type
photo
Media ID
c16b4d12a1556bd4
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 never used another name in this country than that given at the beginning of this form. If so, it was\nI used that name because\nX\nThe full name of the person shown on my steamship ticket was Knut Emprood Samuelsou\nMy mother's maiden name was Anna X Tarabarg\nMy maiden name was (if woman)\nMy post-office address is P.O. Box 27 - myster -form Fature - - Sweden\nThe ticket on which I came to this country was bought at\n(City)\n(Country)\nIf arrival by ship: Name of steamship line was Smedish american\nlat cabin\n2d cabin\n3d cabin\n3rd less\nI arrived as (passenger, stowaway, seaman, member of crew, or otherwise) (State which)\nPassenger\nI traveled on (an immigration visa, a passport, a permit)\nPassport\n(State which)\nI\npaid 30KR (State amount) head tax at (City) (State country) on august (Month) (Day) 27Th-1926 (Year)\nor\nI was\nexamined by immigration officers at my\nAt that time\nI intended to remain (permanently, temporarily, for visit, in transit) (State which)\nThe person in the United States I was coming to was Richard Jedor\npermanently\nSamuelson\nThe place in the United States I was going to was\nProvidence - R.I\n(Give name in full)\nThe names of some of the persons or passengers I traveled with were Arthur Sand\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)\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\nPRINTING OFFICE\n14-\n(OVER)\nKnot Erford (Signature of applicant) danue lson"
}