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File numbers 4874 - 5509, 1926-1930

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I have not used another name in this country than that given at the beginning of this form. If so, it was I used that name becausé The full name of the person shown on my steamship ticket was Walter Pietrowski My mother's maiden name was Julia Daiejma My maiden name was (if woman) My post-office address is 8 Third Street, Norwich, Com The ticket on which I came to this country was bought at New York U. S. A. (City) (Country) let cabin If arrival by ship: Name of steamship line was Frederick VIII 2d-oabin 3rd Cabin 3d cabin I arrived as (passenger, stowaway, seaman, member of crew, or otherwise) passenger (State which) I traveled on (an immigration visa, a passport, a permit) passport (State which) I paid $8.00 head tax at New York U.S.A. , on May 3 1926- (State amount) (City) (State or country) (Month) (Day) (Year) I was examined by immigration officers at Eilis Island At that time I intended to remain (permanently, temporarily, for visit, in transit) permanently (State which) The person in the United States I was coming to was Mase Adela Pietrowski (Aunt)) (Give name in full) The place in the United States I was going to was Norwich, Connectiout The names of some of the persons or passengers I traveled with were Mrc. Jillia Pietrowski Miss Jennie Pietrowski 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) Canada (b) The place in from which I entered the United States was Mexico (c) On (Month) (Day) (Year) (d) The place where I was examined for admission at the United States border was Ellis Island I (e) If not examined, state why, and give the circumstances of your entry Canada The place in Mexico where I bought my railroad ticket to come to the United States was Woodow Natter S. Sictrouski PRINTING ornon 14-8 (OVER) (Signature of applicant)

Page data

Page
1107
Source index
0
Type
photo
Media ID
591d453f075ad438
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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Page context 
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    "ocrText": "I have not used another name in this country than that given at the beginning of this form. If so, it was\nI used that name becausé\nThe full name of the person shown on my steamship ticket was\nWalter Pietrowski\nMy mother's maiden name was\nJulia Daiejma\nMy maiden name was (if woman)\nMy post-office address is\n8 Third Street, Norwich, Com\nThe ticket on which I came to this country was bought at\nNew York\nU. S. A.\n(City)\n(Country)\nlet cabin\nIf arrival by ship: Name of steamship line was\nFrederick VIII\n2d-oabin\n3rd Cabin\n3d cabin\nI arrived as (passenger, stowaway, seaman, member of crew, or otherwise)\npassenger\n(State which)\nI\ntraveled on (an immigration visa, a passport, a permit)\npassport\n(State which)\nI paid\n$8.00 head tax at\nNew York\nU.S.A.\n, on\nMay 3\n1926-\n(State amount)\n(City)\n(State or country)\n(Month)\n(Day)\n(Year)\nI was examined by immigration officers at\nEilis Island\nAt that time I intended to remain (permanently, temporarily, for visit, in transit)\npermanently\n(State which)\nThe person in the United States I was coming to was\nMase Adela Pietrowski (Aunt))\n(Give name in full)\nThe place in the United States I was going to was\nNorwich, Connectiout\nThe names of some of the persons or passengers I traveled with were Mrc. Jillia Pietrowski\nMiss Jennie Pietrowski\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)\nCanada\n(b) The place in\nfrom which I entered the United States was\nMexico\n(c) On\n(Month)\n(Day)\n(Year)\n(d) The place where I was examined for admission at the United States border was Ellis Island\nI\n(e) If not examined, state why, and give the circumstances of your entry\nCanada\nThe place in\nMexico\nwhere I bought my railroad ticket to come to the United States was\nWoodow Natter S. Sictrouski\nPRINTING ornon 14-8\n(OVER)\n(Signature of applicant)"
}