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0120 ORIGINAL 121 JAHI. JAMIDIRO U.S. DEPARTMENT OF LABOR 8108 OF LABOR ORIGINAL NATURALIZATION SERVICE No. to on No. 8109 080.88 STATES E DECLARATION FINTENTION DECLARATION OF INTENTION Invalid for all purposes seven years after the date hereof Invalid for all purposes seven years after the date hereof STATE OF CALIFORNIA In the SUPERIOR Court STATE In the BURERIOR Caunty of Los Angeles ss: The State of California. Caunty Los Angeles f ss: of in and for Los Angeles County, The State of CaNfornia, Court to of Ef and for Los Angeles Courty ge, miss Emma Pink aged #6 years, g, Peter Siemens aged 55 years, occupation nurse , do declare on oath that my personal occupation Ranclu do declare on oath that my personal description is: Color White complexion Fair , height feet 4 inches, description is: Color white complexion medium height 8 inches, weight 120 pounds, color of hair L Brown color of eyes My weight 145 pounds, color of hair DD Brounsolor of leyes Blue other visible distinctive marks none other visible distinctive marks none I was born in 4th of alton England I on the day Dec. on the 80th day of Emarch anno Domini I 859 I now reside was born in Bosengant, Russia (naturalized cantada anno Domini I 867 I now reside at 1079 Oak Knoll Pasadena leal (Give number, street, city of town, and State.) HAVRE, at 120 magnolia (Give number, street, city or town, Ave and State.) Long Beach, Cal I emigrated to the United States of America from I emigrated to the United States of América from victoria, B.C on the vessel Rhyndam : my last on the vessel Princess Louise (If the allen arrived otherwise the character of con avegance or name of transportation company should be given.) (If the alien arrived otherwise than by vessel, the character of conveyance or name of transportation company shonld be given.) : my last foreign residence was London England foreign residence was Plain Couler, man 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 Gloorge V1 King of Great Britain and Ireland. of whom 1 am now.a subject George 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 Seattle in the State of NEW YORK on or about the 16th day State of Washington on or about the 6 the day of april anno Domini 905 1 am not an anarchist: I am not a of november anno Domini (1 914 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 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. miss Emma pgoo Pinh am be So HELP ME GOD. Reter am AJSH Signature (Original aignature of declarast.) to (Original algnature of lo AND le ent Subscribed and sworn to before me in the office of the Clerk of lo silt to Subscribed and sworn to before me in the office of the Clerk of [SEAL.] Court this 30th day of nov. anno Domini 191 4 not lai [SEAL.] arto Court this 30 the day of noun , anno Domini 19t COUNTY CLERK AND EX-OFFICIO CLERK OF THE SUPERIOR IN'AND FOR THE COUNTY H. J. Lelande THE SUPERTOR COURT FOR-THE COUNTY CLERK AND EX-OFFICIO CLERK OF H. J. Letande OF LOS ANGELES. STATE OF CALIFORNIA, OF LOS ANGELES. STATE OF CAL Clerk of the Court. to Clerk of the Court. By Edimitk sech Clerk. 14-06 by diffice Human

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Page context
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    "ocrText": "0120\nORIGINAL\n121\nJAHI.\nJAMIDIRO\nU.S. DEPARTMENT OF LABOR\n8108\nOF LABOR\nORIGINAL\nNATURALIZATION SERVICE\nNo.\nto\non\nNo.\n8109\n080.88\nSTATES\nE\nDECLARATION FINTENTION\nDECLARATION OF INTENTION\nInvalid for all purposes seven years after the date hereof\nInvalid for all purposes seven years after the date hereof\nSTATE OF CALIFORNIA\nIn the\nSUPERIOR\nCourt\nSTATE\nIn the BURERIOR\nCaunty of Los Angeles\nss:\nThe State of California.\nCaunty Los Angeles f\nss:\nof\nin and for Los Angeles County,\nThe State of CaNfornia,\nCourt\nto\nof\nEf and for Los Angeles Courty\nge, miss Emma Pink\naged #6 years,\ng, Peter Siemens\naged 55 years,\noccupation\nnurse\n, do declare on oath that my personal\noccupation Ranclu\ndo declare on oath that my personal\ndescription is: Color White complexion Fair , height feet\n4 inches,\ndescription is: Color white complexion medium height 8 inches,\nweight 120 pounds, color of hair L Brown color of eyes\nMy\nweight 145 pounds, color of hair DD Brounsolor of leyes Blue\nother visible distinctive marks\nnone\nother visible distinctive marks\nnone\nI was born in\n4th of\nalton England\nI\non the\nday\nDec.\non the 80th day of Emarch anno Domini I 859 I now reside\nwas born in Bosengant, Russia (naturalized cantada\nanno Domini I 867 I now reside\nat\n1079 Oak Knoll Pasadena leal\n(Give number, street, city of town, and State.)\nHAVRE,\nat 120 magnolia (Give number, street, city or town, Ave and State.) Long Beach, Cal\nI emigrated to the United States of America from\nI\nemigrated to the United States of América from victoria, B.C\non the vessel\nRhyndam\n: my last\non the vessel\nPrincess Louise\n(If the allen arrived otherwise the character of con avegance or name of transportation company should be given.)\n(If the alien arrived otherwise than by vessel, the character of conveyance or name of transportation company shonld be given.)\n: my last\nforeign residence was\nLondon England\nforeign\nresidence was Plain Couler, man Canada\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\nGloorge V1 King of Great Britain and Ireland.\nof whom 1 am now.a subject\nGeorge V, King of Great Britain and Ireland:\nof whom I am now a subject:\nI arrived at the port of\nNEW YORK\nin the\n1 arrived at the port of Seattle\nin the\nState of\nNEW YORK\non or about the 16th day\nState\nof Washington on or about the 6\nthe day\nof\napril\nanno Domini 905 1 am not an anarchist: I am not a\nof\nnovember anno Domini (1 914 I am not an anarchist; I am not.\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. miss Emma pgoo Pinh am\nbe\nSo HELP ME GOD.\nReter am AJSH\nSignature\n(Original aignature of declarast.)\nto\n(Original algnature of\nlo\nAND\nle\nent Subscribed and sworn to before me in the office of the Clerk of\nlo silt to Subscribed and sworn to before me in the office of the Clerk of\n[SEAL.]\nCourt this 30th day of nov.\nanno Domini 191 4\nnot lai [SEAL.] arto\nCourt this 30 the day of noun , anno Domini 19t\nCOUNTY CLERK AND EX-OFFICIO CLERK OF\nTHE SUPERIOR IN'AND FOR THE COUNTY\nH. J. Lelande THE SUPERTOR COURT FOR-THE\nCOUNTY CLERK AND EX-OFFICIO CLERK OF\nH. J. Letande\nOF LOS ANGELES. STATE OF CALIFORNIA,\nOF LOS ANGELES. STATE OF CAL\nClerk of the\nCourt.\nto Clerk of the\nCourt.\nBy\nEdimitk sech Clerk.\n14-06\nby diffice Human"
}