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THAOLI99A TO Coguard DUPLICATE. 5348 (EDITION OF 1917.] ,deol No. [FORM FOR NATIVE CITIZEN.] is Issued sod eut UNITED STATES OF AMERICA. snoll d STATE OF Arkansas COUNTY OF Pulaski E I, Ella Victoria Caron Coquard a NATIVE AND LOYAL CITIZEN OF THE - - UNITED STATES, hereby apply to the Department of State, at Washington, for a passport. P I solemnly swear that I was born at Minnesots Mins in the State of , Michigan on or about the 10 day of April 1 874; that father my Severen Camon was born in and is now deceased t[that he emigrated to the United States from the port of Three Rivers, Ganada on or about October let , 1 855 that he resided 63 years, uninterruptedly, in the United States, from 1 855 to 1917 at Ill. South Dakota & Ark. ; that he was naturalized as a citizen of the United States before the Cirouit Court of Kankakee Co. Ill , at Kankakee Ill XX es Letter of Clerk C1 roui t Court Kankakee Co Ill that I have resided outside the United States at the following places for the mailed to We shing ton perious xxxxxxxxxx and that I am domiciled in the United States, my permanent residence being at little Rock in the State of Arkansas , where I follow the occupation of Trained Nurse ix I am about to go abroad temporarily; and I (Diposition of passport.) intend to return to the United States within one months with the purpose of residing and per- years forming the duties of citizenship therein; and I desire a passport for use in visiting the countries here- inafter named for the following purpose: France Red Cross Nurse (Name of country.) (Object of visit.) (Name of country.) (Object of visit.) Lanigho od (Name of country.) (Object of visit.) I intend to leave the United States from the port of New York (Port of departure.) sailing on board the on Sept 26th , 191 8 (Name of vessel.) (Date of departure.) OATH OF ALLEGIANCE. Further, I do solemnly swear that I will support and defend the Constitution of the United States against all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; and that I take this obligation freely, without any mental reservation or purpose of evasion: So help meGod. Mrs run (Signature of applicant.) Sworn to before me this 3lst day of September , 19 18 (SEAL OP COURT.] Sid. B. Redding Clerk of the U. S. Dist Court at Little Rock,Ark. [OVER.]

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Document identity
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    "ocrText": "THAOLI99A TO\nCoguard\nDUPLICATE.\n5348\n(EDITION OF 1917.]\n,deol\nNo.\n[FORM FOR NATIVE CITIZEN.]\nis\nIssued\nsod\neut\nUNITED STATES OF AMERICA.\nsnoll\nd\nSTATE OF\nArkansas\nCOUNTY OF Pulaski\nE\nI, Ella Victoria Caron Coquard a NATIVE AND LOYAL CITIZEN OF THE\n-\n-\nUNITED STATES, hereby apply to the Department of State, at Washington, for a passport.\nP\nI solemnly swear that I was born at\nMinnesots Mins\nin the State of\n,\nMichigan\non or about the\n10 day of\nApril\n1 874; that\nfather\nmy\nSeveren Camon\nwas born in\nand is now deceased\nt[that he emigrated to the United States from the port of Three Rivers, Ganada\non or about October let , 1 855 that he resided 63\nyears, uninterruptedly, in\nthe United States, from 1 855 to 1917 at Ill. South Dakota & Ark. ; that he was\nnaturalized as a citizen of the United States before the\nCirouit\nCourt\nof Kankakee Co. Ill\n, at Kankakee Ill\nXX es\nLetter of Clerk C1 roui t Court Kankakee Co Ill\nthat I have resided outside the United States at the following places for the\nmailed to We shing ton\nperious\nxxxxxxxxxx\nand that I am domiciled in the United States, my permanent residence being at\nlittle Rock\nin the State of\nArkansas\n,\nwhere I follow the occupation of\nTrained Nurse\nix\nI am about to go abroad temporarily; and I\n(Diposition of passport.)\nintend to return to the United States within\none\nmonths with the purpose of residing and per-\nyears\nforming the duties of citizenship therein; and I desire a passport for use in visiting the countries here-\ninafter named for the following purpose:\nFrance\nRed Cross Nurse\n(Name of country.)\n(Object of visit.)\n(Name of country.)\n(Object of visit.)\nLanigho od\n(Name of country.)\n(Object of visit.)\nI intend to leave the United States from the port of\nNew York\n(Port of departure.)\nsailing on board the\non\nSept 26th\n, 191 8\n(Name of vessel.)\n(Date of departure.)\nOATH OF ALLEGIANCE.\nFurther, I do solemnly swear that I will support and defend the Constitution of the United States\nagainst all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; and\nthat I take this obligation freely, without any mental reservation or purpose of evasion: So help meGod.\nMrs run (Signature of applicant.)\nSworn to before me this\n3lst day\nof\nSeptember\n, 19 18\n(SEAL OP COURT.]\nSid. B. Redding\nClerk of the U. S. Dist Court at Little Rock,Ark.\n[OVER.]"
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