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Form 2218
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
4890
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.
murial Croasdale mictellaw
; age,
51
years.
Miss
(Allen 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 name because
Tho full of the person shown on my steamship tickst was
My mother S maiden name was
My maiden name was (if woman)
My personal description is: Color, White: complexion, basts
My present occcupation is Housetheeper wife
fair
11/2
; height, 5 feet B inches;
weight, 125 pounds; color of hair, Black
;
other visible distinctive marks:
None
color of eyes, Grey
;
I
was born in moncton new Bremsworest Cauada
(City or town)
(Country)
on the 4
My present residence is 26 ll Paue street Groton new London Connecticat
day of may
1875
,
My post office address is 26 beaue etteel grotow new (County) bondow Connecticut (State)
(Number and street)
(City or town)
The where I took the train which landed in the monctor, new Bunnwell
said
place ship or me United States was
Canada
on betober
1905
,
(Month)
(Day)
(Year)
The ticket on which I came to this country was bought at
The name of the ship or railroad on which I came was (OVER) Intercolomal (City) Ry of Canada (Country) 614-8
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Document data
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- Core
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DTO data
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Context sent to Scholar
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"ocrText": "Form 2218\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n4890\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.\nmurial Croasdale mictellaw\n; age,\n51\nyears.\nMiss\n(Allen should print or typewrite here true, original, and correct name)\n(Give age last 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\nTho full of the person shown on my steamship tickst was\nMy mother S maiden name was\nMy maiden name was (if woman)\nMy personal description is: Color, White: complexion, basts\nMy present occcupation is Housetheeper wife\nfair\n11/2\n; height, 5 feet B inches;\nweight, 125 pounds; color of hair, Black\n;\nother visible distinctive marks:\nNone\ncolor of eyes, Grey\n;\nI\nwas born in moncton new Bremsworest Cauada\n(City or town)\n(Country)\non the 4\nMy present residence is 26 ll Paue street Groton new London Connecticat\nday of may\n1875\n,\nMy post office address is 26 beaue etteel grotow new (County) bondow Connecticut (State)\n(Number and street)\n(City or town)\nThe where I took the train which landed in the monctor, new Bunnwell\nsaid\nplace ship or me United States was\nCanada\non betober\n1905\n,\n(Month)\n(Day)\n(Year)\nThe ticket on which I came to this country was bought at\nThe name of the ship or railroad on which I came was (OVER) Intercolomal (City) Ry of Canada (Country) 614-8"
}