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John tl Walha clerk taberio Cent, Monthing Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 5430 NOT TO BE FILLED IN BY ALIEN U.S. DEPARTMENT OF LABOR FOR USE OF OFFICIALS SEARCHING IMMI- NATURALIZATION SERVICE GRATION RECORDS CLERK OF COURT: RECORDS EXAMINED Place number in CARD INDEX OCT 1 - 1928 - upper left-hand corner of all copies of declaration, immediately under your INDEX BOOKS declaration number. DISTRICT DIRECTOR OF NATURALIZATION MANIFESTS I desire to file my Declaration of Intention (first paper) to become a citizen. Mr. My name is Mrs. miss Alice fareett ; age, 66 years. Miss (Alien should print or typewrite here true, original, and correct name) (Give age last birthday) My present occupation is House maid My personal description is: Color, white complexion, fair ; height, 5 feet 1/2 inches; weight, 145 pounds; color of hair, ; color blue other visible distinctive marks: mole one golden left eyebrow of eyes, ; I was born in townland of (City Largymore, town) (Country) Ireland or on the 1st day of spacil. 863 My present residence is 2071 (Number and street) (City St or town) hew London. (County) bonn. (State) Australton The place where I Rook the ship or train which landed me in the United States was on 4th The name or of the ship railroad on which I came was Insurance Funnesia (Month) may (Day) (Year) 1887 My last place of foreign residence was itylor town) Helean to (Country) Inclased Largymore I am not married. The name of my wife is none She husband was born at He , and now resides at , I am now a subject of and intend to renounce allegiance to Great Briton (Write name and title of sovereign and country of which now a subject; I or, arrived at the United States republic only) new York if citizen of a republic, write name of immigration port of h. (City or town) , on may (State or territory) 14-8 (Give exact month, day, and year) 1887 (OVER)

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1122
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Document data

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Core
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Type
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    "ocrText": "John tl Walha clerk taberio Cent, Monthing\nForm 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5430\nNOT TO BE FILLED IN BY ALIEN\nU.S. DEPARTMENT OF LABOR\nFOR USE OF OFFICIALS SEARCHING IMMI-\nNATURALIZATION SERVICE\nGRATION RECORDS\nCLERK OF COURT:\nRECORDS EXAMINED\nPlace number\nin\nCARD INDEX\nOCT 1 - 1928 -\nupper left-hand corner of all copies of\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 Alice fareett\n; age,\n66\nyears.\nMiss\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nMy present occupation is\nHouse maid\nMy personal description is: Color, white complexion,\nfair\n; height, 5 feet 1/2 inches;\nweight, 145 pounds; color of hair,\n; color blue\nother visible distinctive marks: mole one golden left eyebrow\nof eyes,\n;\nI was born in townland of (City Largymore, town) (Country) Ireland\nor\non\nthe 1st day of\nspacil.\n863\nMy present residence is\n2071 (Number and street) (City St or town) hew London. (County) bonn. (State)\nAustralton\nThe place where I Rook the ship or train which landed me in the United States was\non\n4th\nThe name or\nof the ship railroad on which I came was Insurance Funnesia\n(Month) may (Day)\n(Year) 1887\nMy last\nplace of foreign residence was itylor town) Helean to (Country) Inclased\nLargymore\nI am not married. The name of my\nwife\nis\nnone\nShe\nhusband\nwas born at\nHe\n, and now resides at\n,\nI am now a subject of and intend to renounce allegiance to\nGreat Briton\n(Write name and title of sovereign and country of which now a subject;\nI or, arrived at the United States republic only) new York\nif citizen of a republic, write name of\nimmigration port of\nh.\n(City or town)\n, on\nmay\n(State or territory)\n14-8\n(Give exact month, day, and year)\n1887\n(OVER)"
}