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    "localId": "159596813",
    "label": "File numbers 4874 - 5509, 1926-1930",
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    "contentType": "document",
    "title": "File numbers 4874 - 5509, 1926-1930",
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    "collections": [
        "Naturalization Records of Non-Federal Courts in Connecticut",
        "Applications for Declaration of Intention"
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{
    "seq": 388,
    "pageIndex": 0,
    "type": "photo",
    "url": "https://s3.amazonaws.com/NARAprodstorage/lz/partnerships-0002/18-0177_US-MA/18-0177_US-MA_21/18-0177_US-MA_-4526886-CTN-Applications-for-Declaration-of--1926-1930/18-0177_US-MA_-4526886-CTN-Applications-for-Declaration-of--1926-1930_00388.jpg",
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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5068\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\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMrs.\nOTACK KOZLIN\nJasy\n; age,\n26\nyears.\nMiss\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nMy present occupation\nis SHAUFFER\nLIGHT\n642\nMy personal description is: Color, WHITE ; complexion, MALEI\n; height,\n5 feet to inches;\nweight, 135\nBROWN anbwri\npounds; color of hair,\n; color of eyes,\nBROWN\n;\nother visible distinctive marks:\nNONE\nI was born in\nROGOCHOV\nRUSSIA\n(City or town)\n(Country)\non the\nday of\nDECEMBER 4th , 19.00\nMy present residence is 22 SPRING ST NEW LONDON\nCONN\n(Number and street)\n(City or town)\n(County)\n(State)\nThe place where I took the ship or train which landed me in the United States was\nLABAVA\nLiban t Russia\n,on\nRussia\n(Month)\n(Day)\n(Year)\nThe name of the ship or railroad on which I came was\nsaid\nMy last place of foreign residence was A ROGOCHOV\nRUSSTA\n(City or town)\n(Country)\nI am NOT married. The name of my\nwife\nhusband\n}\nShe\nis\nwas born at\nHe\n, and now resides at\nI am\nnow a subject of and intend to renounce allegiance to (Write name and title of sovereign and country of which now a subject;\nthe statesf lussis\nor, if citizen of a republic, write name of republic only)\nI arrived at the United States immigration port of\nNew\nYork\n(City or town)\nnew (State York terfitory)\n, on 14-8 (Giye exac 12,1907 month, day, and year)\nor\nJuly\n(OVER)"
}