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114 115 - aub at anh NATURALIZATION NATURALIZATION SERVIOE Ne. 61.02 No. 6103 ORIGINAL in STATES OF STATES OF: E DECLARATION OF INTENTION DECLARATION OF INTENTION (levolid for - purposes seven yeare after the date horeof) for - purposes eeven yeare after the date horcof) S STATE OF CALIFORNIÁ) In the SUPERIOR Court STATE,0 FCM FORMIAY S nl In the SUPERIOR Court Cauncy of Los ss: California Caunty of Los Angeles ss: The State of of Angeles County. of in and for Los Angeles County. %, Dam Shultz aged 29 years, %, albert George Sly , aged 40 years, occupation Barber do declare on oath that my personal occupation Salesman do declare on oath that my personal description is: Color White complexion Dark height S feet 3/4 -inches, description is: Color White complexion Fair height 5 feet 8'tz inches, weight 13v pounds, color of hair Dark color of eyes B.Brown weight 162 pounds, color of hair Brown color of eyes Blue I other was visible born in distinctive meenscortze marks noue Russia other visible distinctive marks none I was born in on the IV day of ept anno Domini P83 I now reside on the 16th day of march Worn England , anno Domini I 873; I now reside at 1169 8-51 st (Give Las city Angele or - applyinate. Cal at 1602 n. 12th (Give at Los State.) angeles teal on the vessel Ds Calumbia 1 emigrated to the United States of America from Antwerp Belgaum number, street, city or town, and I emigrated to the United States of America from Sarnia Canada : my last on the vessel Grand Frank By : my last (If given.) the alion arrived otherying than by vessol, the charagter or of Atalion company should be foreign residence was meenkarge Russia (If the allen arrived otherwie than by veasel, the character of conveyance or name of transportation should be given.) foreign residence was Brantford Onlarco Canada 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, Emperor of all the Rus V. King of Great Britain and Ireland. of whom I am now a subject : of whom 1 am now a subject: 1 arrived at the port of NEW YORK in the I arrived at the port- of Port Huron in the State of NEW YORK 6 on or about the day State of mich on or about the 20th day of august anno Domini I 906 1 am not an anarchist: 1 not a am of april . anno Domini 1910 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 fäith to become a citizen of the United States of America and to permanently reside themein: to become a citizen of the United States of America and to permanently reside therein: So HELP ME GOD. So HELP ME. GOD. faill (Origioal shulty of albrt George Sly Algnature (Original signata of Subscribed and swonn to before me this 2 Subscribed and sworn to before me this 2 and [SEAL] day of July , anno Domini 19T 3 [SEAL.] day of July , anno Domini 191 3 H. J. Telanité THE COUNTY CLERK AND EX-OFFICIO CLERIC or COURTY eurex A"D EX-OFFICIO CLIBE or 110 "AND THE courn OF LOS ANGELES. STATE OF CALIFORNIA. ANGELES STATE OF CALIFORNIA. Clak of the Court. Clerk of the Court. By Clerk. By Def Clerk.

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    "ocrText": "114\n115\n- aub\nat anh\nNATURALIZATION\nNATURALIZATION SERVIOE\nNe. 61.02\nNo. 6103\nORIGINAL\nin\nSTATES OF\nSTATES OF:\nE\nDECLARATION OF INTENTION\nDECLARATION OF INTENTION\n(levolid for - purposes seven yeare after the date horeof)\nfor - purposes eeven yeare after the date horcof)\nS\nSTATE OF CALIFORNIÁ)\nIn the\nSUPERIOR Court\nSTATE,0 FCM FORMIAY\nS\nnl\nIn the\nSUPERIOR Court\nCauncy of Los\nss:\nCalifornia\nCaunty of Los Angeles\nss:\nThe State of\nof\nAngeles County.\nof\nin and for Los Angeles County.\n%, Dam Shultz\naged 29 years,\n%, albert George Sly\n, aged 40 years,\noccupation Barber\ndo declare on oath that my personal\noccupation\nSalesman\ndo declare on oath that my personal\ndescription is: Color White complexion Dark\nheight S feet 3/4 -inches,\ndescription is: Color White complexion Fair\nheight\n5 feet 8'tz inches,\nweight 13v pounds, color of hair Dark\ncolor of eyes B.Brown\nweight 162 pounds, color of hair Brown color of eyes Blue\nI other was visible born in distinctive meenscortze marks noue Russia\nother visible distinctive marks\nnone\nI was born in\non the\nIV day of ept\nanno Domini P83 I now reside\non the\n16th day of march\nWorn England\n, anno Domini I 873; I now reside\nat 1169 8-51 st (Give Las city Angele or - applyinate. Cal\nat\n1602 n. 12th (Give at Los State.) angeles teal\non the vessel Ds Calumbia\n1 emigrated to the United States of America from\nAntwerp Belgaum\nnumber, street, city or town, and\nI emigrated to the United States of America from\nSarnia Canada\n: my last\non the vessel\nGrand Frank By\n: my last\n(If given.)\nthe alion arrived otherying than by vessol, the charagter or of Atalion company should be\nforeign residence was\nmeenkarge Russia\n(If the allen arrived otherwie than by veasel, the character of conveyance or name of transportation should be given.)\nforeign residence was\nBrantford Onlarco Canada\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nprince, potentate, state, or sovereignty, and particularly to\nprince, potentate, state, or sovereignty, and particularly to\nNicholas II, Emperor of all the Rus\nV. King of Great Britain and Ireland.\nof whom I am now a subject :\nof whom 1 am now a subject:\n1 arrived at the port of\nNEW YORK\nin the\nI arrived at the port- of\nPort Huron\nin the\nState of\nNEW YORK\n6\non or about the\nday\nState of\nmich\non or about the 20th day\nof\naugust anno Domini I 906 1 am not an anarchist: 1 not a\nam\nof\napril\n.\nanno Domini 1910 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 fäith\nto become a citizen of the United States of America and to permanently reside themein:\nto become a citizen of the United States of America and to permanently reside therein:\nSo HELP ME GOD.\nSo HELP ME. GOD.\nfaill (Origioal shulty of\nalbrt George Sly\nAlgnature\n(Original signata of\nSubscribed and swonn to before me this\n2\nSubscribed and sworn to before me this\n2 and\n[SEAL]\nday of July , anno Domini 19T 3\n[SEAL.]\nday\nof July , anno Domini 191\n3\nH. J. Telanité THE\nCOUNTY CLERK AND EX-OFFICIO CLERIC or\nCOURTY eurex A\"D EX-OFFICIO CLIBE or\n110 \"AND\nTHE courn\nOF LOS ANGELES. STATE OF CALIFORNIA.\nANGELES STATE OF CALIFORNIA.\nClak of the\nCourt.\nClerk of the\nCourt.\nBy\nClerk.\nBy\nDef\nClerk."
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