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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 My mother's maiden name was Elizebeth Waitkowske My maiden name was (if woman) My post-office address is 18 Clay Avenue Horwich, Conn. The ticket on which I came to this country was bought at New York City and sent over. (City) (Country) P 18t gabin If arrival ship: Name of steamship line was Not known Holland Americanline by 3d cabin I arrived as (passenger, stowaway, seaman, member of crew, or otherwise) As passengen (State which) I traveled on (an in imigration visa, a passport, a permit) Immigration Viss (State which) I paid head tax at , on (State amount) (City) (State or country) (Month) (Day) (Year) I was examined by immigration officers at Ellis Island At that time I intended to remain (permanently, temporarily, for visit, in transit) Permanent) (Stato which) The person in the United States I was coming to was Michael Andrulaio (Give name in full) The place in the United States I was going to was Conway Wassachusetts The names of some of the persons or passengers I traveled with were Not known 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) (b) The place in { Canada 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 GOVERNMENT PIMINTING OFFICE 14-8 (OVER) (Signature of applicant)

Page data

Page
1242
Source index
0
Type
photo
Media ID
517c5fb9f89ae676
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\nMy mother's maiden name was Elizebeth Waitkowske\nMy maiden name was (if woman)\nMy post-office address is\n18 Clay Avenue Horwich, Conn.\nThe ticket on which I came to this country was bought at New York City and sent over.\n(City)\n(Country)\nP\n18t gabin\nIf arrival ship: Name of steamship line was Not known Holland Americanline\nby\n3d cabin\nI arrived as (passenger, stowaway, seaman, member of crew, or otherwise) As passengen\n(State which)\nI traveled on (an in imigration visa, a passport, a permit) Immigration Viss\n(State which)\nI paid\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\nAt that time I intended to remain (permanently, temporarily, for visit, in transit) Permanent)\n(Stato which)\nThe person in the United States I was coming to was Michael Andrulaio\n(Give name in full)\nThe place in the United States I was going to was Conway Wassachusetts\nThe names of some of the persons or passengers I traveled with were Not known\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)\n(b) The place in\n{\nCanada\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\nGOVERNMENT PIMINTING OFFICE 14-8\n(OVER)\n(Signature of applicant)"
}