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Page 1213 of 1298
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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 because
The full name of the person shown on my steamship ticket was Sam Horowtiz
My mother's maiden name was Molly Osowsky
My maiden name was (if woman)
My post-office address is
Box #26 Hanover, Connecticut.
The ticket on which I came to this country was bought at
Hemberg, Germany.
(City)
(Country)
If arrival by ship: Name of steamship line was
North German Lloyd.
2dxcakio
3d cabin
I
arrived as (passenger, stowaway, seaman, member of crew, or otherwise)
passenger
(State which)
immigration visa
I traveled on (an immigration visa, a passport, a permit)
(State which)
I paid
no
head tax at
,on
(State amount)
(City)
(State or country)
(Month)
(Day)
(Year)
I was examined by immigration officers at Ellis Island-New York City
At that time I intended to remain (permanently, temporarily, for visit, in transit) permently
(State which)
The person in the United States I was coming to was
A cousin-Harry Goldman
(Give name in full)
The place in the United States I was going to was
New York City Allan Street.
don't remember.
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)
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
(e) If not examined, state why, and give the circumstances of your entry
Canada
(f) The place in
Mexico
where I bought my railroad ticket to come to the United States was
sam Humang
GOVERNMENT PRENTING OFFICE
14-
8
(OVER)
(Signature of applicant)
Page data
- Page
- 1213
- Source index
- 0
- Type
- photo
- Media ID
- 8cf08ffb3c68deb0
- 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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Document source extras
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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 because\nThe full name of the person shown on my steamship ticket was Sam Horowtiz\nMy mother's maiden name was Molly Osowsky\nMy maiden name was (if woman)\nMy post-office address is\nBox #26 Hanover, Connecticut.\nThe ticket on which I came to this country was bought at\nHemberg, Germany.\n(City)\n(Country)\nIf arrival by ship: Name of steamship line was\nNorth German Lloyd.\n2dxcakio\n3d cabin\nI\narrived as (passenger, stowaway, seaman, member of crew, or otherwise)\npassenger\n(State which)\nimmigration visa\nI traveled on (an immigration visa, a passport, a permit)\n(State which)\nI paid\nno\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 Ellis Island-New York City\nAt that time I intended to remain (permanently, temporarily, for visit, in transit) permently\n(State which)\nThe person in the United States I was coming to was\nA cousin-Harry Goldman\n(Give name in full)\nThe place in the United States I was going to was\nNew York City Allan Street.\ndon't remember.\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)\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\n(e) If not examined, state why, and give the circumstances of your entry\nCanada\n(f) The place in\nMexico\nwhere I bought my railroad ticket to come to the United States was\nsam Humang\nGOVERNMENT PRENTING OFFICE\n14-\n8\n(OVER)\n(Signature of applicant)"
}