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Form 2218
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
4934
U. S. DEPARTMENT OF LABOR
NOT TO BE FILLED IN BY ALIEN
FOR USE OF OFFICIALS SEARCHING IMMI-
NATURALIZATION SERVICE
GRATION RECORDS
CLERK OF COURT:
RECORDS EXAMINED
Place number
In
CARD INDEX
upper left-hand corner of all copies of
declaration, immediately under your
INDEX BOOKS
declaration number.
DISTRICT DIRECTOR OF NATURALIZATION.
MANIFESTS
(NOTE TO CLERK OF COURT.-To guide you in preparing the Declaration: The black face lines on this form contain statements
in the regular order as they are to appear on the Declaration of Intention.)
I desire to file my Declaration of Intention (first paper) to become a citizen.
My name is
M
|
Jonef (Alien should print or typewrite Bigos here true, riginal,
; age,
4746 years.
and correct name)
(Give age last birthday)
Also known as
(If alien has used any other name in this country, that name should be shown here)
I used that name because
The full namo of the person shown on my steamship ticket was
My mother E maiden name was
My maiden name was (if woman)
My present occcupation is a weaver
My personal description is: Color, white ; complexion, fair
; height, 5 feet 8 inches;
weight, 155 pounds; color of hair, light ; color of eyes,
;
other visible distinctive marks:
I was born
in
on the 2nd day of (City or town) (Country)
Conn:
My present residence is 100 north Cove & norwich new London
(Number and street)
My post office address is Same S. City (County) Conni (State)
norwich
(City or town)
The place where I took the ship or train which landed me in the United States was
Bremen Germany
new Yonk
, on manily (Month) dib, (Day) / (Year) 1909
The ticket on which I came to this country was bought at
The name of the ship or railroad on which I came was
(OVER)
York
(City)
(Country)
Page data
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Document data
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- Core
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"ocrText": "Form 2218\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n4934\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\nCARD INDEX\nupper left-hand corner of all copies of\ndeclaration, immediately under your\nINDEX BOOKS\ndeclaration number.\nDISTRICT DIRECTOR OF NATURALIZATION.\nMANIFESTS\n(NOTE TO CLERK OF COURT.-To guide you in preparing the Declaration: The black face lines on this form contain statements\nin the regular order as they are to appear on the Declaration of Intention.)\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMy name is\nM\n|\nJonef (Alien should print or typewrite Bigos here true, riginal,\n; age,\n4746 years.\nand correct name)\n(Give age last birthday)\nAlso known as\n(If alien has used any other name in this country, that name should be shown here)\nI used that name because\nThe full namo of the person shown on my steamship ticket was\nMy mother E maiden name was\nMy maiden name was (if woman)\nMy present occcupation is a weaver\nMy personal description is: Color, white ; complexion, fair\n; height, 5 feet 8 inches;\nweight, 155 pounds; color of hair, light ; color of eyes,\n;\nother visible distinctive marks:\nI was born\nin\non the 2nd day of (City or town) (Country)\nConn:\nMy present residence is 100 north Cove & norwich new London\n(Number and street)\nMy post office address is Same S. City (County) Conni (State)\nnorwich\n(City or town)\nThe place where I took the ship or train which landed me in the United States was\nBremen Germany\nnew Yonk\n, on manily (Month) dib, (Day) / (Year) 1909\nThe ticket on which I came to this country was bought at\nThe name of the ship or railroad on which I came was\n(OVER)\nYork\n(City)\n(Country)"
}