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60
JAMIDIRO
ORIGINAL
U.S.DEPARTMENTIOFILABOR
ORIGINAL
No.
8048
1.
0M
No. 8049
E
F
76
DECLARATION OF INTENTION
DECL/RARATION OPINTENTION
Invalid for all purposes seven years aftér the date hereof
B
Invalid for all purposes seven years after the date hereof
STATE OF
ent nl
In the
SUPERIOR Court
STATED n
sill ni
In the
SURERIOR
Caunty of Les Angeles
the State of alifornia
Court
ss:
in and for Los Angeles County.
County of Las Angeles
ss:
The State of California.
to
of
of
in and for Los Angeles County.
ge,
Henry Visser
'aged 36 !years,
John Wulcich Blaine aged
36
years,
oocupation Watchmaker
do declare on oath that my personal
occupation Labour
do declare on oath that my personal
description is: Color White complexion med height 5 feet 10 inches,
descriptión is: Color White complexion Fair height 5 feet 9
weight 140 pounds, color of hair Brown . color of leyes. 9 Grey
weight 190 pounds, color of hair Blonde Grey color of eyes . Blue
other visible distinctive marks
none
rodito
other visible distinctive marks
none
I was born in
Baarn netherlande
I was born in
Brusie Walmacija austria
on the
23th day of
Feby
anno Domini I 878 I now reside
on the
14th
day of
march
anno Domini I 878; 1 now reside
at
345 So. Hope (Give st number, street, Los city and State.) angeles ball
at
232 So main at Lis angeles lead
(Give number, street, city or town, and State.)
I
emigrated to the United States of America from Rotterdam nesthulands
I emigrated to the United States of America from
HAVRE, FRANCE
on the vessel
Potadam
: my last
on the vessel
: my last
(If the allen arrived otherwise than by veasel, the character of conveyance or of company should be given.)
(If the allen anrived than by Veasel, the chargetor of conveyance or name of transportation company should be given.)
La Gascogne
foreign residence was
amstudam netherlanks
foreign residence was
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 Arostolis King of Hungary, of whom I am now a subject:
4 arrived at the port of
Hoboken
in the
I arrived at the port of
NEW YORK
in the
State of
new. Jusey
on or about the 19th day
State of
adi
NEW YORK
, on or about the 27th day
of
June
anno Domini 907 I am not an anarchist I am not
a
of
may
E anno Domini a 902 I am not an anarchist; 1 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.
100 SIM 9J8H oe
So HELP ME GOD.
Henry Kirus
(Origiaal algnature of declarent.)
Juhn Dulcich (Origioal algnature of declarant.) Blame en
Subscribed and sworn to béfore me in the office of the Clerk of
to chalD ard to soltto sdi Subscribed and sworn to béfore me in the office of the Clerk of
2PI [SEAL.]
Court this 16th day of nov.
anno Domini 19:4
104
[SEAL.]
nos -vow Court this 16th day of nor. ,
anno Domini 191 4
CLERKAL -
H. J. Lelande THE "SUPERTOR COURTEN AND FOR THE COUNTY or
COUNTY CLERK AND X-OFFICIO CLERK
10
H.J. Lefande bit SUBERIOR COURT. IN AND FOR THE
OF LDS ANDELES, STATE OF
OF LOS ANGELES. STATE OF CALIFORNIA.
Clerk of the
Court.
all
Clerk of the
Court.
By
Edsmith
Dep
Clerk.
AND
stugy
D6
By
Admish
of
Clerk.
16-56
N-M
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"ocrText": "60\nJAMIDIRO\nORIGINAL\nU.S.DEPARTMENTIOFILABOR\nORIGINAL\nNo.\n8048\n1.\n0M\nNo. 8049\nE\nF\n76\nDECLARATION OF INTENTION\nDECL/RARATION OPINTENTION\nInvalid for all purposes seven years aftér the date hereof\nB\nInvalid for all purposes seven years after the date hereof\nSTATE OF\nent nl\nIn the\nSUPERIOR Court\nSTATED n\nsill ni\nIn the\nSURERIOR\nCaunty of Les Angeles\nthe State of alifornia\nCourt\nss:\nin and for Los Angeles County.\nCounty of Las Angeles\nss:\nThe State of California.\nto\nof\nof\nin and for Los Angeles County.\nge,\nHenry Visser\n'aged 36 !years,\nJohn Wulcich Blaine aged\n36\nyears,\noocupation Watchmaker\ndo declare on oath that my personal\noccupation Labour\ndo declare on oath that my personal\ndescription is: Color White complexion med height 5 feet 10 inches,\ndescriptión is: Color White complexion Fair height 5 feet 9\nweight 140 pounds, color of hair Brown . color of leyes. 9 Grey\nweight 190 pounds, color of hair Blonde Grey color of eyes . Blue\nother visible distinctive marks\nnone\nrodito\nother visible distinctive marks\nnone\nI was born in\nBaarn netherlande\nI was born in\nBrusie Walmacija austria\non the\n23th day of\nFeby\nanno Domini I 878 I now reside\non the\n14th\nday of\nmarch\nanno Domini I 878; 1 now reside\nat\n345 So. Hope (Give st number, street, Los city and State.) angeles ball\nat\n232 So main at Lis angeles lead\n(Give number, street, city or town, and State.)\nI\nemigrated to the United States of America from Rotterdam nesthulands\nI emigrated to the United States of America from\nHAVRE, FRANCE\non the vessel\nPotadam\n: my last\non the vessel\n: my last\n(If the allen arrived otherwise than by veasel, the character of conveyance or of company should be given.)\n(If the allen anrived than by Veasel, the chargetor of conveyance or name of transportation company should be given.)\nLa Gascogne\nforeign residence was\namstudam netherlanks\nforeign residence was\nBrusil\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 Arostolis King of Hungary, of whom I am now a subject:\n4 arrived at the port of\nHoboken\nin the\nI arrived at the port of\nNEW YORK\nin the\nState of\nnew. Jusey\non or about the 19th day\nState of\nadi\nNEW YORK\n, on or about the 27th day\nof\nJune\nanno Domini 907 I am not an anarchist I am not\na\nof\nmay\nE anno Domini a 902 I am not an anarchist; 1 am not\na\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.\n100 SIM 9J8H oe\nSo HELP ME GOD.\nHenry Kirus\n(Origiaal algnature of declarent.)\nJuhn Dulcich (Origioal algnature of declarant.) Blame en\nSubscribed and sworn to béfore me in the office of the Clerk of\nto chalD ard to soltto sdi Subscribed and sworn to béfore me in the office of the Clerk of\n2PI [SEAL.]\nCourt this 16th day of nov.\nanno Domini 19:4\n104\n[SEAL.]\nnos -vow Court this 16th day of nor. ,\nanno Domini 191 4\nCLERKAL -\nH. J. Lelande THE \"SUPERTOR COURTEN AND FOR THE COUNTY or\nCOUNTY CLERK AND X-OFFICIO CLERK\n10\nH.J. Lefande bit SUBERIOR COURT. IN AND FOR THE\nOF LDS ANDELES, STATE OF\nOF LOS ANGELES. STATE OF CALIFORNIA.\nClerk of the\nCourt.\nall\nClerk of the\nCourt.\nBy\nEdsmith\nDep\nClerk.\nAND\nstugy\nD6\nBy\nAdmish\nof\nClerk.\n16-56\nN-M"
}