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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
albred Kellers
My mother's maiden name was
Margarethe Kronnenbrock
My maiden name was (if woman)
--
My post-office address is
Mystic, Conn.
The ticket on which I came to this country was bought at
New London, Conn.
U.S.A.
(City)
(Country)
1st>cabin
If arrival by ship: Name of steamship line was
American Line
2d cabin
3d cabin
I arrived as (passenger, stowaway, seaman, member of crew, or otherwise)
passenger
(State which)
I traveled on (an immigration visa, a passport, a permit)
immigration visa
(State which)
I paid $8.00 head tax
at
New London, Conn.
,on
June 29, 1926
(State amount)
(City)
(State or country)
(Month)
(Day)
(Year)
I was examined by immigration officers at
Koehn
S.Consulate
At that time I intended to remain (permanently, temporarily, for visit, in transit) permanently
(State which)
The person in the United States I was coming to was
Jacob Spicks,
(Give name in full)
The place in the United States I was going to was
Mystic, Conn,
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)
(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
G.Kellas
GOVERNMENT PRENTING ornom 14-
8
(OVER)
(Signature of applicant)
Page data
- Page
- 1268
- Source index
- 0
- Type
- photo
- Media ID
- a8c8289c45112f42
- 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\n--\nThe full name of the person shown on my steamship ticket was\nalbred Kellers\nMy mother's maiden name was\nMargarethe Kronnenbrock\nMy maiden name was (if woman)\n--\nMy post-office address is\nMystic, Conn.\nThe ticket on which I came to this country was bought at\nNew London, Conn.\nU.S.A.\n(City)\n(Country)\n1st>cabin\nIf arrival by ship: Name of steamship line was\nAmerican Line\n2d cabin\n3d cabin\nI arrived as (passenger, stowaway, seaman, member of crew, or otherwise)\npassenger\n(State which)\nI traveled on (an immigration visa, a passport, a permit)\nimmigration visa\n(State which)\nI paid $8.00 head tax\nat\nNew London, Conn.\n,on\nJune 29, 1926\n(State amount)\n(City)\n(State or country)\n(Month)\n(Day)\n(Year)\nI was examined by immigration officers at\nKoehn\nS.Consulate\nAt that time I intended to remain (permanently, temporarily, for visit, in transit) permanently\n(State which)\nThe person in the United States I was coming to was\nJacob Spicks,\n(Give name in full)\nThe place in the United States I was going to was\nMystic, Conn,\nThe names of some of the persons or passengers I traveled with were\n---\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\nG.Kellas\nGOVERNMENT PRENTING ornom 14-\n8\n(OVER)\n(Signature of applicant)"
}