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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5011
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.
Demetrios (Alien should print typewrite here true, original, and gorrect name) , age, (Give age
30
years.
Mics
or
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 shown on my steamship ticket was
My mother's maiden name was Jennie
My maiden name was (if woman)
My present occcupation is Weaver
My personal description is: Color, White ; complexion, dark ; height, 5 feet 7 inches;
weight, 155 pounds; color of hair, black ; color dark of eyes, A brown
;
other visible distinctive marks:
I was born
in Spartant (City or town) none sharthary shattary, (Country) Greece
on the
10
day of
magch
897
My present residence is 27 Elm It newLondon, (County) bonu (State)
Norwich,
(Number and street)
(City or town)
My post office address is 27 Elme st Norwich
11
It
The place where I took the ship or train which landed me in the United States was
haples Italy on January (Month) 77 (Day) 1917 (Year)
The name of the ship or railroad on which I came was Dont reall (City) Sinseppe Italy (Countra Verdi
The ticket on which I came to this country was bought at
naples
(OVER)
averti
e14-8
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Document data
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"ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5011\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.\nDemetrios (Alien should print typewrite here true, original, and gorrect name) , age, (Give age\n30\nyears.\nMics\nor\nlast 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 full name of the person shown on my steamship ticket was\nMy mother's maiden name was Jennie\nMy maiden name was (if woman)\nMy present occcupation is Weaver\nMy personal description is: Color, White ; complexion, dark ; height, 5 feet 7 inches;\nweight, 155 pounds; color of hair, black ; color dark of eyes, A brown\n;\nother visible distinctive marks:\nI was born\nin Spartant (City or town) none sharthary shattary, (Country) Greece\non the\n10\nday of\nmagch\n897\nMy present residence is 27 Elm It newLondon, (County) bonu (State)\nNorwich,\n(Number and street)\n(City or town)\nMy post office address is 27 Elme st Norwich\n11\nIt\nThe place where I took the ship or train which landed me in the United States was\nhaples Italy on January (Month) 77 (Day) 1917 (Year)\nThe name of the ship or railroad on which I came was Dont reall (City) Sinseppe Italy (Countra Verdi\nThe ticket on which I came to this country was bought at\nnaples\n(OVER)\naverti\ne14-8"
}