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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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Document data
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- Core
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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"
}