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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5094
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
I desire to file my Declaration of Intention (first paper) to become a citizen.
Mr.
My name is
Mrs.
RAFFARLe. MALERGA. ; age, 40 0ct 15
years.
Miss
(Alien should print or typewrite here true, original, and correct name)
(Give age last birthday)
My personal description is: Color, white ; complexion, Fairdark ;
My present occupation is
FARMER
31/2
white
height, 5 feet X inches;
weight, 200 pounds; color of hair, Brown
; color of eyes, Brown
;
other visible distinctive marks: scars on forhead
I was born in Italy (City Jerlizzi, or town) Otaly
Bari
(Country)
on the 15
day of oct 1
My present residence is
Route #2
noinich news hondon Conn
(Number and street)
(City or town)
(County)
(State)
The place where I took the ship or train which landed me in the United States was n aples
Italy
on July (Month)
11
1913
(Day)
(Year)
The name or on came
of the ship railroad which I was Saint anonylantana
My last place of foreign residence was said
Terlizzi
Italy
(City or town)
(Country)
married. The name of my
{
wife
I am
}
is
Ross modeybay
She
was born at
husband
He
ItalyProsina Italy and now resides at Route #2
norwich ct.
I am now a subject of and intend to renounce allegiance to
Italy
(Write name and title of sovereign and country of which now a subject;
or, if citizen of a republic, write name of republic only)
I arrived the United States immigration port of new york
at
n.y.
(City or town)
,
on July 14C8 24 1913
(State or territory)
(Give exact month, day, and year)
(OVER)
is
Page data
- Page
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- Source index
- 0
- Type
- photo
- Media ID
- 9ce8cb092b65a178
- Size
- unknown
Document data
- ID
- 159596813
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
Document identity
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Document source metadata
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Document source extras
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Page context
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"ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5094\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.\nRAFFARLe. MALERGA. ; age, 40 0ct 15\nyears.\nMiss\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nMy personal description is: Color, white ; complexion, Fairdark ;\nMy present occupation is\nFARMER\n31/2\nwhite\nheight, 5 feet X inches;\nweight, 200 pounds; color of hair, Brown\n; color of eyes, Brown\n;\nother visible distinctive marks: scars on forhead\nI was born in Italy (City Jerlizzi, or town) Otaly\nBari\n(Country)\non the 15\nday of oct 1\nMy present residence is\nRoute #2\nnoinich news hondon Conn\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 n aples\nItaly\non July (Month)\n11\n1913\n(Day)\n(Year)\nThe name or on came\nof the ship railroad which I was Saint anonylantana\nMy last place of foreign residence was said\nTerlizzi\nItaly\n(City or town)\n(Country)\nmarried. The name of my\n{\nwife\nI am\n}\nis\nRoss modeybay\nShe\nwas born at\nhusband\nHe\nItalyProsina Italy and now resides at Route #2\nnorwich ct.\nI am now a subject of and intend to renounce allegiance to\nItaly\n(Write name and title of sovereign and country of which now a subject;\nor, if citizen of a republic, write name of republic only)\nI arrived the United States immigration port of new york\nat\nn.y.\n(City or town)\n,\non July 14C8 24 1913\n(State or territory)\n(Give exact month, day, and year)\n(OVER)\nis"
}