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Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 5489 U. S. DEPARTMENT OF LABOR NOT TO BE FILLED IN BY ALIEN NATURALIZATION SERVICE FOR USE OF OFFICIALS SEARCHING IMMI- 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. Mrs. Jose Rodrigues , 26 My name is ; age, years. (Alien should print or typewrite here true, original, and correct name) (Give age last birthday) Mics My present occupation is Fishmen My personal description is: Color, White ; complexion, Dakk ; height, 5 feet $7 inches; weight, 128 pounds; color of hair, o Dark Brown ; color of eyes, Light Brown ; other visible distinctive marks: I was born in Praia da Vitoria. Terceira Izores Portual (City or town) (Country) on the 9 day of August 1.202 New London Conn My present residence is 12 Hancox St Stonington (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 Angra do Iroismo Terceira Azores October 15 190 5 , on (Month) (Day) (Year) The name of the ship or railroad on which I came was Peninsular Portuguez Line My last place of foreign residence was Praia da Vitoria. Azores Portugal (City or town) (Country) wife I am married. The name of my } is Constance Henry She was born at husband He- Stonington and now resides at 12 Hancox St. , I am now a subject of and intend to renounce allegiance to Republic of Portugal (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 or town) N. Y, , on November 2 190 5 (State or territory) 14-8 (Give exact month, day, and year) (OVER)

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Document data

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Core
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Type
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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5489\nU. S. DEPARTMENT OF LABOR\nNOT TO BE FILLED IN BY ALIEN\nNATURALIZATION SERVICE\nFOR USE OF OFFICIALS SEARCHING IMMI-\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.\nMrs.\nJose Rodrigues ,\n26\nMy name is\n; age,\nyears.\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nMics\nMy present occupation is Fishmen\nMy personal description is: Color, White ; complexion,\nDakk\n; height, 5\nfeet $7 inches;\nweight,\n128 pounds; color of hair, o Dark Brown\n;\ncolor of eyes, Light Brown\n;\nother visible distinctive marks:\nI was born in Praia da Vitoria.\nTerceira Izores\nPortual\n(City or town)\n(Country)\non the 9\nday of\nAugust\n1.202\nNew London Conn\nMy present residence is\n12 Hancox St\nStonington\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 Angra do Iroismo\nTerceira Azores\nOctober\n15\n190 5\n, on\n(Month)\n(Day)\n(Year)\nThe name of the ship or railroad on which I came was\nPeninsular\nPortuguez Line\nMy last place of foreign residence was\nPraia da Vitoria. Azores\nPortugal\n(City or town)\n(Country)\nwife\nI am\nmarried. The name of my\n}\nis\nConstance Henry\nShe\nwas born at\nhusband\nHe-\nStonington\nand now resides at 12 Hancox St.\n,\nI am now a subject of and intend to renounce allegiance to\nRepublic of Portugal\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\n(City or town)\nN. Y,\n, on November 2 190 5\n(State or territory)\n14-8\n(Give exact month, day, and year)\n(OVER)"
}