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Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 5426 U. S. DEPARTMENT OF LABOR NOT TO BE FILLED IN BY ALIEN TON BERVIOR FOR USE OF OFFICIALS SEARCHING IMMI- NATURAL NATURALIZATION SERVICE GRATION RECORDS REUDIVEL CLERK OF COURT8172 RECORDS EXAMINED AUG 1 1928 Place number Lin CARD INDEX DISTRIC1 DIRECTOR upper left-hand corner of all copies of BOSTON MASS. declaration, immediately under your INDEX BOOKS OF LABOR declaration number. MANIFESTS DATH MEDICINED AVE 1020 I desire to file my Declaration of Intention (first paper) to become a citlzen. IMMIGRATION SERVICE Mr. Mrs. PORD GERIACD SANDS POSTON, My name is Miss My present occupation is Labm Pedro original, Cirians OH, Los Santos OF That age last years. (Alien should print or typewrite here true, and correct namey birthday) My personal description is: Color, white ; complexion, dark ; height, 5 feet 7 inches; weight, 140 pounds; color of hair, black ; color of eyes, darkboown other born in S. Tieute none Is visible distinctive marks: I was (City or town) Controged (Country) on the 12 day of January 1904 My present residence is #2 Houckly St norrich how London, Connt (Number and street) (City or town) (County) (State) The place or me was where I took the ship train which landed in the United States Lisbon Cirtugal , on may 31 1921 (Month) (Day) (Year) The name of the ship or on came was railroad which I T. Vicente My last place of foreign residence was Lisbon (City or town) Portuagel (Country) I am not married. The name of my wife She is husband He } was born at , and now resides at I am now a subject of and intend to renounce allegiance to Resenblic (Write and title of of and country Partugal of which now subject; name sovereign a if citizen of write of I or, arrived. at a the republic, United name States republic immigration only) port of new (City or towa) recoffed mass (State or territory) , on junch (11-6/1921 (Give exact month, day, and 14-14 year) (OVER) 9A

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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5426\nU. S. DEPARTMENT OF LABOR\nNOT TO BE FILLED IN BY ALIEN\nTON BERVIOR\nFOR USE OF OFFICIALS SEARCHING IMMI-\nNATURAL NATURALIZATION SERVICE\nGRATION RECORDS\nREUDIVEL\nCLERK OF\nCOURT8172\nRECORDS EXAMINED\nAUG 1 1928\nPlace number\nLin\nCARD INDEX\nDISTRIC1 DIRECTOR\nupper left-hand corner of all copies of\nBOSTON MASS.\ndeclaration, immediately under your\nINDEX BOOKS\nOF LABOR\ndeclaration number.\nMANIFESTS\nDATH\nMEDICINED\nAVE\n1020\nI desire to file my Declaration of Intention (first paper) to become a citlzen.\nIMMIGRATION SERVICE\nMr.\nMrs.\nPORD GERIACD SANDS\nPOSTON,\nMy name is\nMiss\nMy present occupation is Labm\nPedro original, Cirians OH, Los Santos\nOF That age last\nyears.\n(Alien should print or typewrite here true, and correct namey\nbirthday)\nMy personal description is: Color, white ; complexion, dark\n; height, 5 feet 7 inches;\nweight, 140 pounds; color of hair, black\n; color of eyes, darkboown\nother born in S. Tieute none Is\nvisible distinctive marks:\nI was\n(City or town)\nControged\n(Country)\non the 12\nday\nof January\n1904\nMy present residence is #2 Houckly St norrich how London, Connt\n(Number and street)\n(City or town)\n(County)\n(State)\nThe place or me was\nwhere I took the ship train which landed in the United States Lisbon\nCirtugal\n, on\nmay\n31\n1921\n(Month)\n(Day)\n(Year)\nThe name of the ship or on came was\nrailroad which I T. Vicente\nMy last place of foreign residence was\nLisbon\n(City or town)\nPortuagel\n(Country)\nI am not married. The name of my\nwife\nShe\nis\nhusband\nHe\n}\nwas born at\n, and now resides at\nI am now a subject of and intend to renounce allegiance to\nResenblic (Write and title of of and country Partugal of which now subject;\nname sovereign a\nif citizen of write of\nI or, arrived. at a the republic, United name States republic immigration only) port of new (City or towa)\nrecoffed\nmass\n(State or territory)\n, on junch (11-6/1921 (Give exact month, day, and\n14-14\nyear)\n(OVER)\n9A"
}