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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."
}