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43
ORIGINAL
JAMIDITIO
UDS. DEPARTMENT LABOR
OF LABOR
ORIGINAL
No. 8530
2528 all
No. 8531
DECLARATION FOUNTENTION
DECLARATION OFIINTENTION
Invalid for all purposes seven years after the date hereof
for all purposes seven years aftér the daterhereof:
STATE OF CALIFORMIA)
nl
In
the
SUPERIOR Court
STATE or
nl
In the SUPERIOR Court
of Los
ss:
The State of California.
Caunty of Los Angeles
ss:
The State of Califernia,
to
of
in and for Les Angeles County.
lo
of
in and for Los Angeles County.
& Ferdinand george Briseler aged 49 years,
2109 g, mofsha
aged CM 30 /years,
occupation Iron worker
do declare on oath that my personal
occupation trint Reddler do declare on oath that my personal
,description is: Color complexion sight height 57 feet 6 inches,
white
description is:) Color white complexion : Dark height feet s
inches,
weight 147 pounds, color of hair Blonde color of eyes Blue
weight 170 pounds, color of hair Black color of eyes B noun
other visible distinctive marks
home
aldiziv.
andre
other visible. distinctive marks none 212.11 aviidalt aldializ nadio
I
was born in Chrimbristern, germany
I was born in
grodna Russia
at
and
2011
on the 20 the day of June anno Domini I 865T
now reside
on
the
15th day of april anno Domini I 8857 now reside
at 5102 Lattern (Give number, street, st city towal, and State.) Los angeles Cal
at
or
I emigrated to the United States of America from
Enknown
anting Belgium
the state (Give number, street, city or town, st. and Style.) Los angeles, Cat
I emigrated
: my last
on the vessel
to the United States of America from germany last
on the vessel
(If the allen arrived otherwine than by vossel, the character of conveyance or name of transportation company should be given.)
my
(If the allen arrived otherwise than by veasel, the character of conveyance or name of transportation company should be given.)
foreign residence was
Cologne, generating
foreign residence was
grodua, Russia
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
10
William II. German Emperor.
of whom 1 am now a subject:
Nicholas H. Emperor of all the Russlas.
of whom I am now a subject:
I arrived at the port of
new
your
in the
arrived at the port of
4th day
of new your on or about the 6 th
new york
to trat adt in La in the
of State of Juness new your anno Domini - 900 on 1 or am about not an the anarchist:
State.
day
not a
of
anno Domini a 906 I am not an anarchist: 9 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.
Jackiran d George (Original Brisolan algnatore of declarent.) IM. 9J8H
o2
So HELP ME GOD.
amount
mofsha
orlavich
08
(Origioal signature of declorant.)
to
and
lo
adi Subscribed and sworn to before mé in the office of the Clerk of
to artt to soitto adi Subscribed and sworn to béfore me in the office of the Clerk of
Altro [SEAL.]
Court this 23 day of man anno Domini 19155
in (SEAE.) nows Court this 23 day of mar anno Domini 1913
COUNTY CLERE AND EX-OFFICIO CLERK OF
no -
COUNTY
18° H. J: Lelande COUNTY PERIOR GOURT- COBRIE. as
CLERK AND EXIOFFICIO CLENK of
H. J.Letande mite COMAY TN AND FON THE
LOS ANGELES. CALIFORNIA,
STATE OF
ANGELES STATE OF ALIFORSIA
Clerk of the
Court.
Clerk of the
Court
By Cary Human Deputy 16-46 Clerk.
By Liggin Hindera Depurty 14-68 Clerk.
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"ocrText": "42\n43\nORIGINAL\nJAMIDITIO\nUDS. DEPARTMENT LABOR\nOF LABOR\nORIGINAL\nNo. 8530\n2528 all\nNo. 8531\nDECLARATION FOUNTENTION\nDECLARATION OFIINTENTION\nInvalid for all purposes seven years after the date hereof\nfor all purposes seven years aftér the daterhereof:\nSTATE OF CALIFORMIA)\nnl\nIn\nthe\nSUPERIOR Court\nSTATE or\nnl\nIn the SUPERIOR Court\nof Los\nss:\nThe State of California.\nCaunty of Los Angeles\nss:\nThe State of Califernia,\nto\nof\nin and for Les Angeles County.\nlo\nof\nin and for Los Angeles County.\n& Ferdinand george Briseler aged 49 years,\n2109 g, mofsha\naged CM 30 /years,\noccupation Iron worker\ndo declare on oath that my personal\noccupation trint Reddler do declare on oath that my personal\n,description is: Color complexion sight height 57 feet 6 inches,\nwhite\ndescription is:) Color white complexion : Dark height feet s\ninches,\nweight 147 pounds, color of hair Blonde color of eyes Blue\nweight 170 pounds, color of hair Black color of eyes B noun\nother visible distinctive marks\nhome\naldiziv.\nandre\nother visible. distinctive marks none 212.11 aviidalt aldializ nadio\nI\nwas born in Chrimbristern, germany\nI was born in\ngrodna Russia\nat\nand\n2011\non the 20 the day of June anno Domini I 865T\nnow reside\non\nthe\n15th day of april anno Domini I 8857 now reside\nat 5102 Lattern (Give number, street, st city towal, and State.) Los angeles Cal\nat\nor\nI emigrated to the United States of America from\nEnknown\nanting Belgium\nthe state (Give number, street, city or town, st. and Style.) Los angeles, Cat\nI emigrated\n: my last\non the vessel\nto the United States of America from germany last\non the vessel\n(If the allen arrived otherwine than by vossel, the character of conveyance or name of transportation company should be given.)\nmy\n(If the allen arrived otherwise than by veasel, the character of conveyance or name of transportation company should be given.)\nforeign residence was\nCologne, generating\nforeign residence was\ngrodua, Russia\nIt is my bona fide intention. to renounce forever all allegiance and fidelity to any foreign\nIt\nis 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\n10\nWilliam II. German Emperor.\nof whom 1 am now a subject:\nNicholas H. Emperor of all the Russlas.\nof whom I am now a subject:\nI arrived at the port of\nnew\nyour\nin the\narrived at the port of\n4th day\nof new your on or about the 6 th\nnew york\nto trat adt in La in the\nof State of Juness new your anno Domini - 900 on 1 or am about not an the anarchist:\nState.\nday\nnot a\nof\nanno Domini a 906 I am not an anarchist: 9 am\nnot\na\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 God.\nJackiran d George (Original Brisolan algnatore of declarent.) IM. 9J8H\no2\nSo HELP ME GOD.\namount\nmofsha\norlavich\n08\n(Origioal signature of declorant.)\nto\nand\nlo\nadi Subscribed and sworn to before mé in the office of the Clerk of\nto artt to soitto adi Subscribed and sworn to béfore me in the office of the Clerk of\nAltro [SEAL.]\nCourt this 23 day of man anno Domini 19155\nin (SEAE.) nows Court this 23 day of mar anno Domini 1913\nCOUNTY CLERE AND EX-OFFICIO CLERK OF\nno -\nCOUNTY\n18° H. J: Lelande COUNTY PERIOR GOURT- COBRIE. as\nCLERK AND EXIOFFICIO CLENK of\nH. J.Letande mite COMAY TN AND FON THE\nLOS ANGELES. CALIFORNIA,\nSTATE OF\nANGELES STATE OF ALIFORSIA\nClerk of the\nCourt.\nClerk of the\nCourt\nBy Cary Human Deputy 16-46 Clerk.\nBy Liggin Hindera Depurty 14-68 Clerk."
}