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have used another name in this country than that given at the beginning of this form. If so, it was I used that name because The full name of the person shown on my steamship ticket was My mother's maiden name was Ann Rebuca barter My maiden name was (if woman) My post-office address is The ticket on which I came to this country was bought at (City) (Country) If by ship: Name of steamship line was arrival bunard 1st cabin 2d cabin transport 3d cabin I arrived (passenger, stowaway, seaman, member of crew, otherwise) soldier as or (State which) - I traveled on (an immigration visa, a passport, a permit) (State which) I paid - head tax at ,on (State amount) (City) (State or country) (Month) (Day) (Year) I was examined by immigration officers at At that time I intended to remain (permanently, temporarily, for visit, in transit) The person in the United States I was coming to was Permanently (State which) (Give nanie in full) eithe 471 Kenor n.y) The place in the United States I was going to was Dont sembers J.A. Scott Co: n.L. The names of some of the persons or passengers I traveled with were ADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME FROM OR THROUGH CANADA OR MEXICO: (a) The place in Canada where I landed was , on (Month) (Day) (Year) br (b) The place in { Canada from which I entered the United States was Mexico (of On (Month) (Day) (Year) (d) The place where I was examined for admission at the United States border was (e) If not examined, state why, and give the circumstances of your entry 1 { Canada (f) The place in Mexico where I bought my railroad ticket to come to the United States was GOVERNOMENT PRENTING 14-8 (OVER) (Signature of applicant)

Page data

Page
1060
Source index
0
Type
photo
Media ID
99000f5ed8f6947f
Size
unknown

Document data

ID
159596813
Core
doc
Type
document
DTO data
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Context sent to Scholar

Document identity
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Document source metadata
{
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    "sourceUrl": "https://catalog.archives.gov/id/159596813",
    "contentType": "document",
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Document source extras
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Page context
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    "seq": 1060,
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    "ocrText": "have\nused another name in this country than that given at the beginning of this form. If so, it was\nI used that name because\nThe full name of the person shown on my steamship ticket was\nMy mother's maiden name was Ann Rebuca barter\nMy maiden name was (if woman)\nMy post-office address is\nThe ticket on which I came to this country was bought at\n(City)\n(Country)\nIf by ship: Name of steamship line was\narrival bunard\n1st cabin\n2d cabin\ntransport\n3d cabin\nI arrived (passenger, stowaway, seaman, member of crew, otherwise) soldier\nas or\n(State which)\n-\nI traveled on (an immigration visa, a passport, a permit)\n(State which)\nI paid\n-\nhead tax at\n,on\n(State amount)\n(City)\n(State or country)\n(Month)\n(Day)\n(Year)\nI was examined by immigration officers at\nAt that time I intended to remain (permanently, temporarily, for visit, in transit)\nThe person in the United States I was coming to was\nPermanently (State which)\n(Give\nnanie in full) eithe 471 Kenor\nn.y)\nThe place in the United States I was going to was Dont sembers J.A. Scott Co: n.L.\nThe names of some of the persons or passengers I traveled with were\nADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME FROM OR THROUGH CANADA OR MEXICO:\n(a) The place in Canada where I landed was\n, on\n(Month)\n(Day)\n(Year)\nbr\n(b) The place in\n{\nCanada\nfrom which I entered the United States was\nMexico\n(of On\n(Month)\n(Day)\n(Year)\n(d) The place where I was examined for admission at the United States border was\n(e) If not examined, state why, and give the circumstances of your entry\n1\n{\nCanada\n(f) The place in\nMexico\nwhere I bought my railroad ticket to come to the United States was\nGOVERNOMENT PRENTING 14-8\n(OVER)\n(Signature of applicant)"
}