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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
4874
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 my Declaration of Intention (first paper) to become a citizen.
Mr.
My name is
Mrs.
(Alien should agint or typewrite here true original correct
; age, 43
years.
Miss
Also known as
Raphael (II Those and name) syah (Givelage here)
last birthday)
alien has used any other name in this country, that name should be shown
I used that name because
The full name of the person shown en my steamohip ticket was
My mother S manden Was
My moiden name (if
My present occcupation is Hawn Weaver
dark
93/4
My personal description is: Color, Whits ; complexion, Bed
; height, 5 feet
inches;
weight, 160 pounds; color darkBrown of hair,
; color of eyes, Brown
;
onback visiblé distinctive marks: tattooing
other
i
was born in Syrow (City or town) gabil Syria, (Country) Surkey
on
the 3rd day of
My present residence is 333 main st nouruch ,
July
1 883
lonn
(Number and street)
(City or town)
(County)
(State)
My post office address is 333 main st.
The place where I took the ship or train which landed me in the United States was Beyeath
naples, tickes which I Italy this
, on Sep.
20 1913
(Month)
(Day)
(Year)
The canro to wag bought at
The
name of the ship or railroad on which I came was (City) (Country)
(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\n4874\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 my Declaration of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMrs.\n(Alien should agint or typewrite here true original correct\n; age, 43\nyears.\nMiss\nAlso known as\nRaphael (II Those and name) syah (Givelage here)\nlast birthday)\nalien has used any other name in this country, that name should be shown\nI used that name because\nThe full name of the person shown en my steamohip ticket was\nMy mother S manden Was\nMy moiden name (if\nMy present occcupation is Hawn Weaver\ndark\n93/4\nMy personal description is: Color, Whits ; complexion, Bed\n; height, 5 feet\ninches;\nweight, 160 pounds; color darkBrown of hair,\n; color of eyes, Brown\n;\nonback visiblé distinctive marks: tattooing\nother\ni\nwas born in Syrow (City or town) gabil Syria, (Country) Surkey\non\nthe 3rd day of\nMy present residence is 333 main st nouruch ,\nJuly\n1 883\nlonn\n(Number and street)\n(City or town)\n(County)\n(State)\nMy post office address is 333 main st.\nThe place where I took the ship or train which landed me in the United States was Beyeath\nnaples, tickes which I Italy this\n, on Sep.\n20 1913\n(Month)\n(Day)\n(Year)\nThe canro to wag bought at\nThe\nname of the ship or railroad on which I came was (City) (Country)\n(OVER)\n014-8"
}