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Mrs.
3
a
IMPORTANT
We request that you make application for passport immediately so that you
may fill in the questions listed below and return this blank in the attached
envelope.
1. Name
Mrs. Martha Selby blark,
2. Address
658 N. Frazier St., Phila., Pa.
3.
Place of birth Pliia - Penna
4.
Date of birth June 28 the 1878- 221 Dickirsen Penna st
5.
6. Court or Agency of State Department at which application was filed at
In emergency notify pospe Selty. pliia -
United States 20 i strict bourt. Pliia - Perma
7.
*83
Address prior to date of sailing 658 N. Trajier 8t
Date application was filed July 25th .
Philadelphia. Perma
*If it is impossible to comply with the above at this time we would requast
that you keep us informed by wire of any changes in your address, as it may be
very important that we communicate with you regarding changes in date of sailing.
ES
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"ocrText": "Mrs.\n3\na\nIMPORTANT\nWe request that you make application for passport immediately so that you\nmay fill in the questions listed below and return this blank in the attached\nenvelope.\n1. Name\nMrs. Martha Selby blark,\n2. Address\n658 N. Frazier St., Phila., Pa.\n3.\nPlace of birth Pliia - Penna\n4.\nDate of birth June 28 the 1878- 221 Dickirsen Penna st\n5.\n6. Court or Agency of State Department at which application was filed at\nIn emergency notify pospe Selty. pliia -\nUnited States 20 i strict bourt. Pliia - Perma\n7.\n*83\nAddress prior to date of sailing 658 N. Trajier 8t\nDate application was filed July 25th .\nPhiladelphia. Perma\n*If it is impossible to comply with the above at this time we would requast\nthat you keep us informed by wire of any changes in your address, as it may be\nvery important that we communicate with you regarding changes in date of sailing.\nES"
}