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60 61 JAVILIDIRO ORIGINAL U.S. AMPIRO UJS. DEPARTHENTOFOLABOR ORIGINAL No. 8048 1.4 e .6M No. 8049 6W STATESTOF E = DECLARATION GENINTENTION DECLARATION OFINTENTION B Invalid for all purposes seven years after the date hereof Invalid for all' purposes seven years after the date hereof STATE OF enti nl In the SUPERIOR Court STATEL El and n° SURERIOR In the Court Caunty of Les Angeles ss: The State of California th and for Los Angeles County. County of Las Angelee ss: The State of California. lo of of in and for Los Angeles County. g, Henry Visser aged 36 Fyears, oocupation Watchmaker John Labour Wulcich Blaine aged 36 years, do declare on oath that my personal occupation do declare on oath that my personal description is: Color White , complexion med height 5 feet 10 inches, description its: Color White complexion Fair , height 5 feet 9 (zinches, weight color of hair 140 pounds, Brown color of leyes q, any weight 190 pounds, color of hair Blonde Gray color of eyes Blue other visible distinctive marks none aldiali. other visible distinctive marks none I was born in Baarn netherlande I was born in Brusie Walmacija austria on the 23th of day Feby , anno Domini I 878 I now reside on the 14th day of march anno Domini 1878; 1 now reside at 345 So. Hope (Give st number, atreet, Loe city or Jomp, and angelic leal at 232 So main at Lis State.) angeles lead (Give number, atreet, alty or town, and 1 emigrated to the United States of America from Rotterdam nesthulands 1 emigrated to the United States of America from HAVRE, FRANCE on'thervessel Potadam : my last on the vessel La Gascogne : my last (If the allen arrived otherwise than by veasel, the character of conveyance or - et transpogtation company should be given.) (ue the allen arrived oth than the chan oter of conveyance or name of transportation company should be given.) foreign residence was amstedam netherlands foreign residence was a Brusil austria 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 foreigh prince, potentate, state, or sovereignty, and particularly to prince, potentate, state, or sovereignty, and particularly to Wilhelmina, Queen of the Netherlands. of whom 1 am now a subject Francis Joseph, Emparor of Austria Arostolic King of Hungary, of whom I am now a subject: 4 arrived at the port of Hoboken be in the I arrived at the port of NEW YORK in-the State of new Jusey on or about the 19th day State of NEW YORK , on or about the 27th day of (111. June anno Domini 907: I am not an anarchist: I am not a of may anno Domini 902 1 am not an anarchist: I am not a polygamist nor a believer in the practice of polygamy: and lit ris 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. and SM oa So HELP ME GOD. Henry (Original Visser John Dulcich (Original alguasure of declarant.) Blame to Subscribed and sworn to béfore me in the office of the Clerk of to >holo adt to solito arti Subscribed and sworn to béfore me in the office of the Clerk of to: in [SEAL.] Court this 16th day of nov. anno Domini 191 tot [SEAL.] nhu wow Court this 16th day of not Domini 191 anno 4 disuary LERK AND EX-OFFICIO - H. J. Lelande COURY AND IN AND EX-OFFICIO FOR THE CLERK COUNTY or COUNTY CLERK H.J. Lelanile the SUBERIOR COURT IN AND FOR THE COUNTE OF LOS ANGELES. STATE OF OF LOS ANGELES. STATE OF CALIFORNIA. Clerk of the Court. und Clerk of the Court. By Edmith Dep Clerk. By Edmist of Clerk. 14-M 14-86

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    "ocrText": "60\n61\nJAVILIDIRO\nORIGINAL\nU.S.\nAMPIRO\nUJS. DEPARTHENTOFOLABOR\nORIGINAL\nNo. 8048\n1.4 e .6M\nNo. 8049\n6W\nSTATESTOF\nE\n=\nDECLARATION GENINTENTION\nDECLARATION OFINTENTION\nB\nInvalid for all purposes seven years after the date hereof\nInvalid for all' purposes seven years after the date hereof\nSTATE OF\nenti nl\nIn the\nSUPERIOR Court\nSTATEL El\nand n°\nSURERIOR\nIn the\nCourt\nCaunty of Les Angeles\nss:\nThe State of California\nth and for Los Angeles County.\nCounty of Las Angelee\nss:\nThe State of California.\nlo\nof\nof\nin and for Los Angeles County.\ng,\nHenry Visser\naged 36 Fyears,\noocupation Watchmaker\nJohn Labour Wulcich Blaine aged 36 years,\ndo declare on oath that my personal\noccupation\ndo declare on oath that my personal\ndescription is: Color White , complexion med height\n5 feet 10 inches,\ndescription its: Color White complexion Fair , height 5 feet 9 (zinches,\nweight color of hair\n140 pounds, Brown color of leyes q, any\nweight 190 pounds, color of hair Blonde Gray color of eyes Blue\nother visible distinctive marks\nnone\naldiali.\nother visible distinctive marks none\nI was born in\nBaarn netherlande\nI was born in\nBrusie Walmacija austria\non the\n23th of\nday\nFeby\n, anno Domini I 878 I now reside\non the 14th day of march\nanno Domini 1878; 1 now reside\nat\n345 So. Hope (Give st number, atreet, Loe city or Jomp, and angelic leal\nat\n232 So main at Lis State.) angeles lead\n(Give number, atreet, alty or town, and\n1 emigrated to the United States of America from Rotterdam nesthulands\n1 emigrated to the United States of America from\nHAVRE, FRANCE\non'thervessel\nPotadam\n: my last\non the vessel\nLa Gascogne\n: my last\n(If the allen arrived otherwise than by veasel, the character of conveyance or - et transpogtation company should be given.)\n(ue the allen arrived oth than the chan oter of conveyance or name of transportation company should be given.)\nforeign residence was\namstedam netherlands\nforeign residence was a Brusil\naustria\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 foreigh\nprince, potentate, state, or sovereignty, and particularly to\nprince, potentate, state, or sovereignty, and particularly to\nWilhelmina, Queen of the Netherlands.\nof whom 1 am now a subject\nFrancis Joseph, Emparor of Austria Arostolic King of Hungary, of whom I am now a subject:\n4 arrived at the port of\nHoboken\nbe in the\nI arrived at the port of\nNEW YORK\nin-the\nState of\nnew Jusey\non or about the 19th day\nState of\nNEW YORK\n, on or about the 27th day\nof (111. June\nanno Domini 907: I am not an anarchist: I am not\na\nof\nmay\nanno Domini 902 1 am not an anarchist: I am not a\npolygamist nor a believer in the practice of polygamy: and lit ris 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.\nand SM oa\nSo HELP ME GOD.\nHenry (Original Visser\nJohn Dulcich (Original alguasure of declarant.) Blame\nto\nSubscribed and sworn to béfore me in the office of the Clerk of\nto >holo adt to solito arti Subscribed and sworn to béfore me in the office of the Clerk of\nto: in [SEAL.]\nCourt this 16th day of nov.\nanno Domini 191\ntot [SEAL.] nhu wow Court this 16th day of not Domini 191\nanno 4\ndisuary LERK AND EX-OFFICIO -\nH. J. Lelande COURY AND IN AND EX-OFFICIO FOR THE CLERK COUNTY or\nCOUNTY CLERK\nH.J. Lelanile the SUBERIOR COURT IN AND FOR THE COUNTE\nOF LOS ANGELES. STATE OF\nOF LOS ANGELES. STATE OF CALIFORNIA.\nClerk of the\nCourt.\nund Clerk of the\nCourt.\nBy\nEdmith Dep Clerk.\nBy\nEdmist\nof\nClerk.\n14-M\n14-86"
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