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a 12 13 of Euber at anh Tuber NATURALIZATION SERVIOE NATURALIZATION No. 6000 ORIGINAL 6001 No. ORIGINAL STATES OF STATES OF 4 5 DECLARATION OF INTENTION DECLARATION: OR INTENTION (Invalid for all purposes seven years after the date hereof) (lavalid for all purposes seven yeara after the daté hereof) STATE OF In the SUPERIOR Gourt STATE SUPERIOR In the Caunty of Los Angeles ss: Caunty Codrt The State of Califórnia. ss: The State of of in and for Los Angeles County. of in and for Los Angeles County. g, meyer Lavin aged 27 years, ge, John Beanchamp nicholem aged 59 years, occupation Failor , do declare on oath that my personal occupation architect do declare on oath that my personal description is: Color white complexion med , height 5 feet 8 inches, description is: Color which complexion Light height 5 feet 81/2 Finches, weight 150 pounds, color of hair Brown , color of eyes Blue weight 170 pounds, color of hair Bay , color of eyes Blue other visible distinctive marks none other visible distinctive marks Spear wound over left Eye I was born in yedee minsk Russia I was born in London on the 20 day of England 836 Lord st (Qive number, fls street, city or town. angeles beal may anno Domini I 886 ; I now reside on the 15th day of July anno Domini 1 853 ; I now reside at at 1829 manifur an Los angeles cal BURG. GERMANY (Give number, atreet, alty town, and State.) I emigrated to the United States of America from I emigrated to the United States of America fror OUTHAMPTON, ENGLAND on the vessel america : my last on the vessel st Lours (If the allen arrived otherwise than by veasel, the character of conveyance or name of transportation company should be given.) ; my last (II the allen arrived ofherwise than by vessol, the character of ogaveyance or naque of transportation company should be giren.) foreign residence was yade minsk Russia foreign residence was Johanneling South africa It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign prince, potentate, state, or sovereignty, and particularly to prince, potentate, state, or sovereignty, and particularly to Nicholas II, Eurperor of all the Russias of whom I am now a subject Geo. V. King of Great Britain and Ireland of whom I am now a subject: I arrived at the port of NEW YORK in the 1 arrived at the port of NEW VORK in the State of NEW YORK on or about the 24th day State of NEW YORK on or. about the 20th day of Dec anno Domini 906; I am not an anarchist: I am not a of march anno Domini I 908: 1 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. meyer havin So HELP ME GOD. Beauchange hicholou oa (Original algnature of declarant.) (Origiaal algpature of declarant.) alda Subscribed and sworn to before me this 7th and Subscribed and sworn to before me this 7th [SEAL.] day of gune anno Domini 191 31 [SEAL.] day of June anno Domini 191 3 COUNTY CLERK AND EX-OFFICIO OF H. J. Lelande IN AND CALIFORNIA. FOR THE COUNTY H. J Lefando IN AMP FOR THE COUNTE COUNTY CLERK AND. EX-DEFACIO. CLERK - LUB AUGELES. STATE OF Clerk of the Court. ANDELES. STATE OF CALIFORNIA. Clerk of the Court By of Clerk. By sech Clark.

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