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ORIGINAL
you
No. 2931.
ORIGINAL
STATES of
STATES of
Department of Comunterce and Tabor
Departutent of Tahor
BUREAU OF IMMIGRATION AND NATURALIZATION
BUREAU OF IMMIGRATION AND NATURALIZATION
DIVISION OF NATURALIZATION
DIVISION. OF NATURALIZATION
DECLARATION OF INTENTION
DECLARATION OF INTENTION
(Invalid for all purposes seven years after the date hereof)
(Inva)id for all purposes seven years after the date hereof)
m
P
STATE af CALLFORNIA
In the
SUPERIOR Court
County.of Los Angeles
ss :
STATE OF: CAMI CHORNIA
THE STATE of CALIFORNIA,
County of Lios Auge(es
In the SUPERIOR
ss:
THE STATE OF CALIFORNIA,
Court
of
INLAND FOR Los ANGELES Ceunty.
of
IN AND FOR Los ANGELES.
3.
nikala Simor Pravitya
aged
22 years,
3. Johan Wittelstelt
, aged 32
miner
do affirm on that my personal
declare oath
occupation Labour
years,
occupation
, do declare on oath
description is: Color while
description is: Color White complexion Fair affirm- height
that my personal
complexion Dark height 6 feet - inches,
, feet inches,
weight 180 pounds, color of hair Brown color of eyes Brown
weight 144 pounds, color of hair Brown , color of eyes Blue
other visible distinctive marks
none
other visible distinctive marks
none
:
I was born in Bosbinjo
Austria
on the
25 of November. , anno
day
Russia
,
on the
: I was born 12th in Hollinja
,
Domini I 888 I now reside at
has Angeles bal.
day of august , anno
Domini 878 : I now reside at
I emigrated to the United States of America from Haven France
Long Beach Healif
on the vessel
Imperial
: my last
on
I emigrated the vessel to the Cincinnatte United States of America from Hamburg Germany
(If the allen arrived otherwise than by vessal, the Character of conveyance or nase of transportatio company should be given.)
foreign residence was
Inibinjo
Austria
(If the allen arrived thandy vessel, the Character of conveyance or name of transportation company should be given.] ; my last
foreign residence was
Bheniga
Pussia
It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign
prince, potentate, state, or sovereignty, and particularly to Transin guah Emperon
It is my bona fide intention to renodnce forever all allegiance and figelity to any foreign
prince, potentate, state, or sovereignty, and particularly to Nicholas II
of Rustriak Spribalis King of Hungary of which I am now a subject
I
Kewyork
Comperor of Russia
of which I am now a citisen subject I
arrived at the port of
in the
arrived at the port of
State
State
new york
in the
Tactitory of
Newyork.
on or about the age, day
Tossitory of
District
Dietrict
anno Domini 905 am not an anarchist: I am not
of
July
New york
on or about the 11th day
of
may
a
, anno Domini 909; I am not an anarchist: I am not a
polygamist nor a believer in the practice of polygamy and it is my intention in good faith
polygamist nor a believer in the practice of polygamy: and it is my intention in good faith
to become a citizen of the United States of America and to permanently reside therein:
to become a citizen of the United States of America and to permanently reside therein:
So HELP ME
GOD. work (Original signature of declarant.) Rovilage
Nikolasime
So HELP ME GOD.
Johan mittelstedt
(Original signature of declarant.)
Subscribed and sworn affiemed to before me this
25
Subscribed sworn to 25th
and affirmed before me this
[SEAL.
day
of november. anno Domini 1910
[SEAL
day of November anno Domini 1910
C.. g. Keyes
C G. Keyes
COUNTYTEL ARUTY -
THE SUPE HIOR COURT IN le COUNTY
GOUNTY CLERK AND EX DEFICIO
Piz -
-
class of the OF LOS ANGELES,STATE OF GALIFORNIA,
THE SUPERIOR COURT IN ALLD FOR THE GOUNTY
By
for tunday
or Loe ANGELES, STATE OF SALIFORNIA,
Apuly
Clerk.
By Wr Scott
Defuty Clerk.
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"ocrText": "ORIGINAL\nyou\nNo. 2931.\nORIGINAL\nSTATES of\nSTATES of\nDepartment of Comunterce and Tabor\nDepartutent of Tahor\nBUREAU OF IMMIGRATION AND NATURALIZATION\nBUREAU OF IMMIGRATION AND NATURALIZATION\nDIVISION OF NATURALIZATION\nDIVISION. OF NATURALIZATION\nDECLARATION OF INTENTION\nDECLARATION OF INTENTION\n(Invalid for all purposes seven years after the date hereof)\n(Inva)id for all purposes seven years after the date hereof)\nm\nP\nSTATE af CALLFORNIA\nIn the\nSUPERIOR Court\nCounty.of Los Angeles\nss :\nSTATE OF: CAMI CHORNIA\nTHE STATE of CALIFORNIA,\nCounty of Lios Auge(es\nIn the SUPERIOR\nss:\nTHE STATE OF CALIFORNIA,\nCourt\nof\nINLAND FOR Los ANGELES Ceunty.\nof\nIN AND FOR Los ANGELES.\n3.\nnikala Simor Pravitya\naged\n22 years,\n3. Johan Wittelstelt\n, aged 32\nminer\ndo affirm on that my personal\ndeclare oath\noccupation Labour\nyears,\noccupation\n, do declare on oath\ndescription is: Color while\ndescription is: Color White complexion Fair affirm- height\nthat my personal\ncomplexion Dark height 6 feet - inches,\n, feet inches,\nweight 180 pounds, color of hair Brown color of eyes Brown\nweight 144 pounds, color of hair Brown , color of eyes Blue\nother visible distinctive marks\nnone\nother visible distinctive marks\nnone\n:\nI was born in Bosbinjo\nAustria\non the\n25 of November. , anno\nday\nRussia\n,\non the\n: I was born 12th in Hollinja\n,\nDomini I 888 I now reside at\nhas Angeles bal.\nday of august , anno\nDomini 878 : I now reside at\nI emigrated to the United States of America from Haven France\nLong Beach Healif\non the vessel\nImperial\n: my last\non\nI emigrated the vessel to the Cincinnatte United States of America from Hamburg Germany\n(If the allen arrived otherwise than by vessal, the Character of conveyance or nase of transportatio company should be given.)\nforeign residence was\nInibinjo\nAustria\n(If the allen arrived thandy vessel, the Character of conveyance or name of transportation company should be given.] ; my last\nforeign residence was\nBheniga\nPussia\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nprince, potentate, state, or sovereignty, and particularly to Transin guah Emperon\nIt is my bona fide intention to renodnce forever all allegiance and figelity to any foreign\nprince, potentate, state, or sovereignty, and particularly to Nicholas II\nof Rustriak Spribalis King of Hungary of which I am now a subject\nI\nKewyork\nComperor of Russia\nof which I am now a citisen subject I\narrived at the port of\nin the\narrived at the port of\nState\nState\nnew york\nin the\nTactitory of\nNewyork.\non or about the age, day\nTossitory of\nDistrict\nDietrict\nanno Domini 905 am not an anarchist: I am not\nof\nJuly\nNew york\non or about the 11th day\nof\nmay\na\n, anno Domini 909; I am not an anarchist: I am not a\npolygamist nor a believer in the practice of polygamy and it is my intention in good faith\npolygamist nor a believer in the practice of polygamy: and it is my intention in good faith\nto become a citizen of the United States of America and to permanently reside therein:\nto become a citizen of the United States of America and to permanently reside therein:\nSo HELP ME\nGOD. work (Original signature of declarant.) Rovilage\nNikolasime\nSo HELP ME GOD.\nJohan mittelstedt\n(Original signature of declarant.)\nSubscribed and sworn affiemed to before me this\n25\nSubscribed sworn to 25th\nand affirmed before me this\n[SEAL.\nday\nof november. anno Domini 1910\n[SEAL\nday of November anno Domini 1910\nC.. g. Keyes\nC G. Keyes\nCOUNTYTEL ARUTY -\nTHE SUPE HIOR COURT IN le COUNTY\nGOUNTY CLERK AND EX DEFICIO\nPiz -\n-\nclass of the OF LOS ANGELES,STATE OF GALIFORNIA,\nTHE SUPERIOR COURT IN ALLD FOR THE GOUNTY\nBy\nfor tunday\nor Loe ANGELES, STATE OF SALIFORNIA,\nApuly\nClerk.\nBy Wr Scott\nDefuty Clerk."
}