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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5112
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.
21
years.
Miss
(Alien should print or typewrite here true, original, and correct name)
(Give agé last birthday)
My present occupation is
Velvel Weaven
; complexion,
dark
8 4/4
My personal description is: Color, White
; height, 5 feet $ inches;
weight, 137 pounds; color of hair, black ; color of dark brown
eyes,
other
visible distinctive marks: Scarson left thumb
I was born in
Canada
(City or town)
(Country)
on
the day of January
11th
, 1906
My present residence
is Lisbend
tours of Lictory
Conn.
(Number and street)
(City or town)
train which landed in the United States this Karnham
said (County)
(State)
The place where I took the ship
or me was
Central on Oct. (Month)
/ 1906
(Day)
(Year)
The
name
of the ship or railroad on which I came was Central Leamont Railsoad
said
My last place of foreign residence was
West Farnham Canada
A
(City or town)
(Country)
I am not married. The name of my
wife
}
She
is
was born at
husband
He
and now resides at
I am now a subject of and intend to renounce allegiance to
Gins (Write George, name and title/of sovereign and Vreak Brition of which
country now a subject;
or, if citizen of a republic, write name of republic only)
I arrived at the United States immigration port of
Vermond
mewpopt
our 2nd
(City or town)
, on
1906
(State or territory)
14-8
(Give exact month, day, and year)
(OVER)
Page data
- Page
- 476
- Source index
- 0
- Type
- photo
- Media ID
- 1a8360f0be2ef247
- 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\n5112\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.\n21\nyears.\nMiss\n(Alien should print or typewrite here true, original, and correct name)\n(Give agé last birthday)\nMy present occupation is\nVelvel Weaven\n; complexion,\ndark\n8 4/4\nMy personal description is: Color, White\n; height, 5 feet $ inches;\nweight, 137 pounds; color of hair, black ; color of dark brown\neyes,\nother\nvisible distinctive marks: Scarson left thumb\nI was born in\nCanada\n(City or town)\n(Country)\non\nthe day of January\n11th\n, 1906\nMy present residence\nis Lisbend\ntours of Lictory\nConn.\n(Number and street)\n(City or town)\ntrain which landed in the United States this Karnham\nsaid (County)\n(State)\nThe place where I took the ship\nor me was\nCentral on Oct. (Month)\n/ 1906\n(Day)\n(Year)\nThe\nname\nof the ship or railroad on which I came was Central Leamont Railsoad\nsaid\nMy last place of foreign residence was\nWest Farnham Canada\nA\n(City or town)\n(Country)\nI am not married. The name of my\nwife\n}\nShe\nis\nwas born at\nhusband\nHe\nand now resides at\nI am now a subject of and intend to renounce allegiance to\nGins (Write George, name and title/of sovereign and Vreak Brition of which\ncountry now a subject;\nor, if citizen of a republic, write name of republic only)\nI arrived at the United States immigration port of\nVermond\nmewpopt\nour 2nd\n(City or town)\n, on\n1906\n(State or territory)\n14-8\n(Give exact month, day, and year)\n(OVER)"
}