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    "localId": "159596813",
    "label": "File numbers 4874 - 5509, 1926-1930",
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    "contentType": "document",
    "title": "File numbers 4874 - 5509, 1926-1930",
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        "Naturalization Records of Non-Federal Courts in Connecticut",
        "Applications for Declaration of Intention"
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{
    "seq": 1052,
    "pageIndex": 0,
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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5400\nU. S. DEPARTMENT OF LABOR\nNOT TO BE FILLED IN BY ALIEN\nFOR USE OF OFFICIALS SEARCHING IMMI-\nNATURALIZATION SERVICE\nGRATION RECORDS\nCLERK OF COURT:\nRECORDS EXAMINED\nPlace number\nin\nupper left-hand corner of all copies of\nCARD INDEX\ndeclaration, immediately under your\nINDEX BOOKS\ndeclaration number.\nDISTRICT DIRECTOR OF NATURALIZATION\nMANIFESTS\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMrs.\nMiss\n}\nHAIM SIWANIK\n34\n; age,\nyears.\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nMy present occupation is Foreman Shor factory\nMy personal description is: Color, white ; complexion, light\n; height, 5 feet 3% inches;\nweight, 138 pounds; color of hair, Dam Brown ; color of eyes, Grey\n;\nother visible distinctive marks:\n-\nI was born in\nBreat - Litowark\nPoland\n(City or town)\n(Country)\non the\n10\nday of nonember\n1894\nMy present residence is 357armcount St nourich, newhoudh Come.\n(Number and street)\n(City or town)\n(County)\n(State)\nThe place where I took the ship or train which landed me in the United States was Southampton Engloud\n, on\nEnd of October 1904\n(Month)\n(Day)\n(Year)\nThe of the ship railroad which I was St. Louis\nname or on came\nMy last place of foreign residence was Brest- Litowark\nPolared\n(City or town)\n(Country)\nwife\nis Sophie\nShe\nI am\nmarried. The name of my\n}\nwas born at\nluchand\nCrernawoxyce, Polaud\nand now resides at\nsaidy 35 Fairmount ft\nRebolland\nI am now a subject of and intend to renounce allegiance to\n(Write name and title of sovereign and country of which now a subject;\nor, if citizen of a republic, write name of republic only)\nI\narrived at the United States immigration port of (City town)\nnew-york-litty\nor\nnew your\n(State or territory)\n, on november 14-8 (Give month, day, about and year) th13th 1199\nexact\n(OVER)"
}