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File numbers 4874 - 5509, 1926-1930

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Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 4946 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 CARD INDEX upper left-hand corner of all copies of declaration, immediately under your INDEX BOOKS declaration number. DISTRICT DIRECTOR OF NATURALIZATION. MANIFESTS (NOTE TO CLERK OF COURT.-To guide you in preparing the Declaration: The black face lines on this form contain statements in the regular order as they are to appear on the Declaration of Intention.) I desire to file Intention to a citizen. Mr. My name is Mrs. John my Declaration (Alien should print of or Perkausta typewrite here (first true, original, paper) and correct become name) 36 ; age, years. Miss (Give age last birthday) Also known as (If alien has used any other name in this country, that name should be shown here) I used that name because The full name of the person My mother's maiden name was Meorourd gord' shown on my steamship ticket was fay Perkowske My maiden name was (if woman) My present occcupation is Journer gunshop My personal description is: Color, which ; complexion, for ; height, 5 feet 5 inches; weight, 150 pounds; color of hair, brown ; color of eyes, gry brown other visible distinctive marks: sean am left unit I was born in (City town) , Russinour TA (Country) Calana or on the 11 day of Month 1890 My present residence is 36 Mechani , nonwich Com (Number and street) Shi (City or town) (County) (State) My post office address is some The place ticket on which I came to this country was bought at Wooth (City) gereasy (Day) (Country) (Year) Germany where I took the ship or train which landed me in the United States was Hountury , on 25th (Month) June 1910 The The name of the ship or railroad on which I came was President (OVER) grout c14-8

Page data

Page
143
Source index
0
Type
photo
Media ID
5884b983db6c6b69
Size
unknown

Document data

ID
159596813
Core
doc
Type
document
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Context sent to Scholar

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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n4946\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\nCARD INDEX\nupper left-hand corner of all copies of\ndeclaration, immediately under your\nINDEX BOOKS\ndeclaration number.\nDISTRICT DIRECTOR OF NATURALIZATION.\nMANIFESTS\n(NOTE TO CLERK OF COURT.-To guide you in preparing the Declaration: The black face lines on this form contain statements\nin the regular order as they are to appear on the Declaration of Intention.)\nI desire to file Intention to a citizen.\nMr.\nMy name is\nMrs.\nJohn my Declaration (Alien should print of or Perkausta typewrite here (first true, original, paper) and correct become name)\n36\n; age,\nyears.\nMiss\n(Give age last birthday)\nAlso known as\n(If alien has used any other name in this country, that name should be shown here)\nI used that name because\nThe\nfull\nname\nof\nthe\nperson\nMy mother's maiden name was Meorourd gord'\nshown on my steamship ticket was fay Perkowske\nMy maiden name was (if woman)\nMy\npresent occcupation is Journer gunshop\nMy personal description is: Color, which ; complexion, for\n; height, 5 feet 5 inches;\nweight, 150 pounds; color of hair, brown ; color of eyes, gry brown\nother visible distinctive marks: sean am left unit\nI was born in (City town) , Russinour TA (Country) Calana\nor\non the 11\nday of\nMonth\n1890\nMy\npresent\nresidence is 36 Mechani , nonwich Com\n(Number and street)\nShi\n(City or town)\n(County)\n(State)\nMy post office address is\nsome\nThe place\nticket on which I came to this country was bought at Wooth (City) gereasy (Day) (Country) (Year)\nGermany\nwhere I took the ship or train which landed me in the United States was Hountury\n,\non 25th (Month) June\n1910\nThe\nThe\nname of the ship or railroad on which I came was President (OVER) grout\nc14-8"
}