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I have
- 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 full name of the person shown on my steamship ticket was
My mother's maiden name was
Heline Leclere
My
maiden name was (if woman) Marie Amma Daigneult
My post-office address
The ticket on which I came to this country was bought at St Heacinthe (City
is Taftvelle Coun P.C Boy 108
(Country)
1st cabin
If arrival by ship: Name of steamship line was
2d cabin
3d cabin
I arrived as seaman, crew, or
(passenger, stowaway, member of otherwise) passenger (State which)
I traveled on (an immigration visa, a passport, a permit) permit
head tax at Canada , on (Month) may (Day) 18 (Year) 1924
(State which)
I paid 8,00
(State amount)
(Cits
(State or country)
I was examined by immigration officers at montreal
At that time I (permanently, temporarily, for visit, in transit)
intended to remain
permanently
(State which)
The person in the United States I was coming to was Whitiber Chicoine
(Give name in full)
The place in the United States I going to Taftvelle comm
was was
The names of some of the or I traveled with were
persons passengers Exdras Daigneault
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) May (Day) 8 1224 (Year)
(b) The place in
{
Canada
from which I entered the United States was SL:Alban ,
Mexico
(c) On
(Month)
(d) The place where II was examined for admission at the United States border was montreal
my
5
1924
(Day)
(Year)
by the doctor
(e) If not examined, state why, and give the circumstances of your entry
-
Canada
(f) The place in
where bought my the United States St Heyanne
I railroad ticket to come to was
Mexico
mde Silas Beaubice
14 8
(OVER)
(Signature of applicant)
Page data
- Page
- 958
- Source index
- 0
- Type
- photo
- Media ID
- 901f197e1786fbe5
- Size
- unknown
Document data
- ID
- 159596813
- Core
- doc
- Type
- document
DTO data
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"title": "File numbers 4874 - 5509, 1926-1930",
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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\n- used another name in this country than that given at the beginning of this form. If so, it was\n-\nI used that name because\n-\nThe full name of the person shown on my steamship ticket was\nMy mother's maiden name was\nHeline Leclere\nMy\nmaiden name was (if woman) Marie Amma Daigneult\nMy post-office address\nThe ticket on which I came to this country was bought at St Heacinthe (City\nis Taftvelle Coun P.C Boy 108\n(Country)\n1st cabin\nIf arrival by ship: Name of steamship line was\n2d cabin\n3d cabin\nI arrived as seaman, crew, or\n(passenger, stowaway, member of otherwise) passenger (State which)\nI traveled on (an immigration visa, a passport, a permit) permit\nhead tax at Canada , on (Month) may (Day) 18 (Year) 1924\n(State which)\nI paid 8,00\n(State amount)\n(Cits\n(State or country)\nI was examined by immigration officers at montreal\nAt that time I (permanently, temporarily, for visit, in transit)\nintended to remain\npermanently\n(State which)\nThe person in the United States I was coming to was Whitiber Chicoine\n(Give name in full)\nThe place in the United States I going to Taftvelle comm\nwas was\nThe names of some of the or I traveled with were\npersons passengers Exdras Daigneault\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) May (Day) 8 1224 (Year)\n(b) The place in\n{\nCanada\nfrom which I entered the United States was SL:Alban ,\nMexico\n(c) On\n(Month)\n(d) The place where II was examined for admission at the United States border was montreal\nmy\n5\n1924\n(Day)\n(Year)\nby the doctor\n(e) If not examined, state why, and give the circumstances of your entry\n-\nCanada\n(f) The place in\nwhere bought my the United States St Heyanne\nI railroad ticket to come to was\nMexico\nmde Silas Beaubice\n14 8\n(OVER)\n(Signature of applicant)"
}