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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5483
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
upper left-hand corner of all copies of
CARD INDEX
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
mickael Szarra Michael Szarka
age,
31
years.
(Alien should print or typewrite here true, original, and correct name)
(Give age last birthday)
Miss
My present occupation is Mill-hand
My personal description is: Color, white
; complexion,
Medium
; height,
b feet 7th inches;
weight, 155
pounds; color of hair,
Brown
; color of eyes,
Blue
;
other visible distinctive marks:
NONE mades on neck
I was born in Butrimáci
Russia NOW Poland
(City or town)
(Country)
on the Fourth day of November
, 1 891
18 Clay Avenue
My present residence is Norwich, Connecticut
New London, County
Connecticut
(Number and street)
(City or town)
(County)
(State)
The place where I took the ship or train which landed me in the United States was at Rotterdam, Netherlands
-
March
,on
1909
(Month)
(Day)
(Year)
The name of the ship or railroad on which I came was Not known.
My last place of foreign residence was
Woitekmie
Poland
(City or town)
(Country)
wife
She
I am
married. The name of my
is
Veronica Szarka
husband
}
was born at
the
Tuchowe, Poland
,
and
now resides at jorwich, Conn.
,
I am now a subject of and intend to renounce allegiance to
Poland
(Write name and title of sovereign and country of which now a subject;
or, if citizen of a republic, write name of republic only)
I arrived at the United States immigration port of
New York City
(City or town)
New York State
on April 9, 1909.
,
(State or territory)
14-8
(Give exact month, day, and year)
(OVER)
Page data
- Page
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- Source index
- 0
- Type
- photo
- Media ID
- 8166673bff761271
- 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": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5483\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\nupper left-hand corner of all copies of\nCARD INDEX\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\nmickael Szarra Michael Szarka\nage,\n31\nyears.\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nMiss\nMy present occupation is Mill-hand\nMy personal description is: Color, white\n; complexion,\nMedium\n; height,\nb feet 7th inches;\nweight, 155\npounds; color of hair,\nBrown\n; color of eyes,\nBlue\n;\nother visible distinctive marks:\nNONE mades on neck\nI was born in Butrimáci\nRussia NOW Poland\n(City or town)\n(Country)\non the Fourth day of November\n, 1 891\n18 Clay Avenue\nMy present residence is Norwich, Connecticut\nNew London, County\nConnecticut\n(Number and street)\n(City or town)\n(County)\n(State)\nThe place where I took the ship or train which landed me in the United States was at Rotterdam, Netherlands\n-\nMarch\n,on\n1909\n(Month)\n(Day)\n(Year)\nThe name of the ship or railroad on which I came was Not known.\nMy last place of foreign residence was\nWoitekmie\nPoland\n(City or town)\n(Country)\nwife\nShe\nI am\nmarried. The name of my\nis\nVeronica Szarka\nhusband\n}\nwas born at\nthe\nTuchowe, Poland\n,\nand\nnow resides at jorwich, Conn.\n,\nI am now a subject of and intend to renounce allegiance to\nPoland\n(Write name and title of sovereign and country of which now a subject;\nor, if citizen of a republic, write name of republic only)\nI arrived at the United States immigration port of\nNew York City\n(City or town)\nNew York State\non April 9, 1909.\n,\n(State or territory)\n14-8\n(Give exact month, day, and year)\n(OVER)"
}