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Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 4950 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 they are to appear on, the Declaration of Intention.) I desire to file my Declaration of Intention (fryst paper) to become a citizen. Francisger Mr. Mrs. Frank Tory My name is ; age, 4039 years. Miss (Alien should print or typewrite here true, original, and correct name) (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 because The full name name of the person shown on my steamship ticket was Franciorek To orz My mother's maiden name was frames Walkuska My maiden name was (if woman) My present occcupation is labour du te forending 5/14 My personal description is: Color, White ; complexion, durk ; 5 feet X inches; height, weight, 175 pounds; color of hair, my ; color of eyes, gny brown other visible distinctive marks: I was born in on the 14 day of December (City or town) (Country) My present residence is 56- (Number and street) (City Norwich, or town) (County) Coun (State) , 1887 myersan, My post office address is Amil as abon The place where I took the ship train which landed in the United States was Hanchurg or me The Hermany , on 27. (Month) april 1409 ticket on which I came to this country was bought at Prosthi (Day) (Year) (City) (Country) The name of the ship or railroad on which I came was America (OVER) 014-8

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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n4950\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\nthe regular order they are to appear on, the Declaration of Intention.)\nI desire to file my Declaration of Intention (fryst paper) to become a citizen.\nFrancisger\nMr.\nMrs.\nFrank Tory\nMy name is\n; age, 4039 years.\nMiss\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nAlso known as\n-\n(If alien has used any other name in this country, that name should be shown here)\nI used that because\nThe full name name of the person shown on my steamship ticket was Franciorek To orz\nMy mother's maiden name was frames Walkuska\nMy maiden name was (if woman)\nMy present occcupation is labour du te forending 5/14\nMy personal description is: Color, White ; complexion, durk ; 5 feet X inches;\nheight,\nweight, 175 pounds; color of hair, my\n; color of eyes, gny brown\nother visible distinctive marks:\nI was born in\non the 14\nday of\nDecember\n(City or town)\n(Country)\nMy present residence is 56- (Number and street) (City Norwich, or town) (County) Coun (State)\n, 1887\nmyersan,\nMy post office address is Amil as abon\nThe place where I took the ship train which landed in the United States was Hanchurg\nor me\nThe\nHermany\n,\non 27. (Month) april\n1409\nticket on which I came to this country was bought at Prosthi\n(Day)\n(Year)\n(City)\n(Country)\nThe name of the ship or railroad on which I came was\nAmerica\n(OVER)\n014-8"
}