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Form 2218
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5058
U. S. DEPARTMENT OF LABOR
NOT TO BE FILLED IN BY ALIEN
FOR USE OF OFFICIALS SEARCHING IMMI-
NATURALIZATION SERVICE
KEAU
GRATION RECORDS
NATURALIZA
CLERK OF COURT:
RECEIVED
32030
RECORDS EXAMINED
Place number
in
CARD INDEX
NATURALIZATION SERVICAL
upper left-hand corner of all copies of
RECEIVED
declaration, immediately under your
INDEX BOOKS
ACKND
declaration number.
FEB 1881927
DISTRICT DIRECTOR OF NATURALIZATION.
MANIFESTS
OFFICE OF
CONN.
(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.
Richard Buch Buch ;
age,
2526 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 name because
The full name of the person shown on my steamship ticket was Richard Buch
My mother's maiden name was
adelgunde Stox
My maiden name was (if woman)
My present occcupation is
Blacksmith and mechaniker 83/4
My personal description is: Color, White ; complexion, ; height, 5 feet gt inches;
Fairlight
weight, 170 pounds; color of hair, Blond light ; color of eyes, Blue
;
other visible distinctive marks:
I was born in
Edsew
(City or town)
Germany
(Country)
on the
7
day of
June
gol
My present residence is 95 Water (Number and street) street (City (County)
Storington
boun,
My post office address is P.O.03 223
or town)
(State)
The 8 place where Brewen I took the ship or train which landed me in the United States was germany
, on
may
9
1925
(Month)
(Day)
(Year)
The ticket on which I came to this country was bought at
new (City) York
(Country)
The name of the ship or railroad on which I came was
Mindehew
(OVER)
C/A issued
014-8
AFR 11 1927
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"ocrText": "Form 2218\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5058\nU. S. DEPARTMENT OF LABOR\nNOT TO BE FILLED IN BY ALIEN\nFOR USE OF OFFICIALS SEARCHING IMMI-\nNATURALIZATION SERVICE\nKEAU\nGRATION RECORDS\nNATURALIZA\nCLERK OF COURT:\nRECEIVED\n32030\nRECORDS EXAMINED\nPlace number\nin\nCARD INDEX\nNATURALIZATION SERVICAL\nupper left-hand corner of all copies of\nRECEIVED\ndeclaration, immediately under your\nINDEX BOOKS\nACKND\ndeclaration number.\nFEB 1881927\nDISTRICT DIRECTOR OF NATURALIZATION.\nMANIFESTS\nOFFICE OF\nCONN.\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.\nRichard Buch Buch ;\nage,\n2526 years.\nMiss\n(Alien 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\nThe full name of the person shown on my steamship ticket was Richard Buch\nMy mother's maiden name was\nadelgunde Stox\nMy maiden name was (if woman)\nMy present occcupation is\nBlacksmith and mechaniker 83/4\nMy personal description is: Color, White ; complexion, ; height, 5 feet gt inches;\nFairlight\nweight, 170 pounds; color of hair, Blond light ; color of eyes, Blue\n;\nother visible distinctive marks:\nI was born in\nEdsew\n(City or town)\nGermany\n(Country)\non the\n7\nday of\nJune\ngol\nMy present residence is 95 Water (Number and street) street (City (County)\nStorington\nboun,\nMy post office address is P.O.03 223\nor town)\n(State)\nThe 8 place where Brewen I took the ship or train which landed me in the United States was germany\n, on\nmay\n9\n1925\n(Month)\n(Day)\n(Year)\nThe ticket on which I came to this country was bought at\nnew (City) York\n(Country)\nThe name of the ship or railroad on which I came was\nMindehew\n(OVER)\nC/A issued\n014-8\nAFR 11 1927"
}