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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 5028 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 upper left-hand corner of all copies of CARD INDEX declaration, immediately under your INDEX BOOKS declaration number. DISTRICT DIRECTOR OF NATURALIZATION MANIFESTS I desire to file my Declaration of Intention (first paper) to become a citizen. Mr. My name is Mrs. / CHARLES, EDWARD, FORTII ; age, 23. 28 Sept. years. Miss (Alien should print or typewrite here true, original, and correct name) (Give age last birthday) My present occupation is Bakers dark 714 My personal description is: Color, white ; complexion, Brank ; height, 5 feet to inches; weight, 165 pounds; color of hair, brown ; color of eyes, brown ; other visible distinctive marks: Scarson liftside I was born in Dunnonvilly Rte Canada (City or town) (Country) on the 28 day of September 1903 My present residence is Baltic stragut domne (Number and street) (City or town) (County) (State) The place ship where I took the or train which landed me in the United States was the place when took the training Sherbrack canada on The name of the ship or railroad on which I came was (Month) (Day) Pacific (Year) My last place Bailroad of foreign residence was ssaidserbrook (City or town) (Country) I am not married. The name of my wife She is was horn at huswand He and now resides at , I am now a subject of and intend to renounce allegiance to Gurge (Write name and V, title of sovereign to and 1 country of which now a subject; or, if citizen of a republic, write name of republic I arrived at the United States (State or immigration territory) only) port of Newport, may (OVER) fon (City Vermont or 16, town) 1917 14-8 (Give exact month, day, and year)

Page data

Page
307
Source index
0
Type
photo
Media ID
c77097e5e8de2f8b
Size
unknown

Document data

ID
159596813
Core
doc
Type
document
DTO data 
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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\n5028\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\nupper left-hand corner of all copies of\nCARD INDEX\ndeclaration, immediately under your\nINDEX BOOKS\ndeclaration number.\nDISTRICT DIRECTOR OF NATURALIZATION\nMANIFESTS\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMrs.\n/\nCHARLES, EDWARD, FORTII\n; age, 23. 28 Sept. years.\nMiss\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nMy present occupation is Bakers\ndark\n714\nMy personal description is: Color, white ; complexion, Brank\n; height, 5 feet to inches;\nweight, 165 pounds; color of hair, brown\n; color of eyes, brown\n;\nother visible distinctive marks: Scarson liftside\nI\nwas born in Dunnonvilly Rte Canada\n(City or town)\n(Country)\non the 28\nday of September\n1903\nMy present residence is\nBaltic stragut domne\n(Number and street)\n(City or town)\n(County)\n(State)\nThe place ship\nwhere I took the or train which landed me in the United States was the place when\ntook the training Sherbrack canada on\nThe name of the ship or railroad on which I came was (Month) (Day) Pacific (Year)\nMy last place\nBailroad of foreign residence was\nssaidserbrook\n(City or town)\n(Country)\nI am not married. The name of my\nwife\nShe\nis\nwas horn at\nhuswand\nHe\nand now resides at\n,\nI am now a subject of and intend to renounce allegiance to Gurge (Write name and V, title of sovereign to and 1 country\nof which now a\nsubject;\nor, if citizen of a republic, write name of republic\nI\narrived at the United States\n(State or\nimmigration territory) only) port of Newport, may (OVER) fon (City Vermont or 16, town) 1917\n14-8 (Give exact month, day, and year)"
}