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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5158
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
upper left-hand corner of all copies of
CARD INDEX
declaration, immediately under your
INDEX BOOKS
declaration number.
DISTRICT DIRECTOR OF NATURALIZATION
MANIFESTS
Martia anna Agiedgis
I desire to file my Declaration of Intention (first paper) to become a citizen.
Mr.
My name is
Mrs.
MARY AMANA DIVEDZIG age,
44 43 years.
(Alien should print or typewrite here true, original, and correct name)
(Give age last birthday)
Miss-
My present occupation is Farming
My personal description is: Color, White ; complexion, light tin
dark
4x
; height,
feet
1134
(inches;
weight, 127 pounds; color of hair, dark brown ; color of eyes, haze l
;
other visible distinctive marks:
none
I was born in Emilawka
Russia
(City or town)
(Country)
on the 22nd day of November
1 +83
My norwich, present residence is R#5 (Number Box and street) 64, (City or town) N.Landan, (County) (State) Cann
briawald
The place where I took the ship or train which landed me in the United States was Bremen
Semaning
Bremen
on may (Month) - (Day) 1903 (Year)
The name of the ship or railroad on which I came was
My last place of foreign residence was Biale
balicia
(City or town)
wident
t
wife
I am not married. The name or my
j Bindic (Country)
She
wag born at
husband
He
,
and now resides at
,
I am now a subject of and intend to renounce allegiance to
Polared Russia
(Write name and title of sovereign and country of which now a subject;
if citizen of a write name of
I or, arrived at the republic, United States republic immigration only) port of
4.y
(City or town)
new york (State n.y. or territory)
, on June 14-8
1903
(Give exact month, day, and year)
(OVER)
Page data
- Page
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- Source index
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- Type
- photo
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- Size
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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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"ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5158\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\nupper left-hand corner of all copies of\nCARD INDEX\ndeclaration, immediately under your\nINDEX BOOKS\ndeclaration number.\nDISTRICT DIRECTOR OF NATURALIZATION\nMANIFESTS\nMartia anna Agiedgis\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMrs.\nMARY AMANA DIVEDZIG age,\n44 43 years.\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nMiss-\nMy present occupation is Farming\nMy personal description is: Color, White ; complexion, light tin\ndark\n4x\n; height,\nfeet\n1134\n(inches;\nweight, 127 pounds; color of hair, dark brown ; color of eyes, haze l\n;\nother visible distinctive marks:\nnone\nI was born in Emilawka\nRussia\n(City or town)\n(Country)\non the 22nd day of November\n1 +83\nMy norwich, present residence is R#5 (Number Box and street) 64, (City or town) N.Landan, (County) (State) Cann\nbriawald\nThe place where I took the ship or train which landed me in the United States was Bremen\nSemaning\nBremen\non may (Month) - (Day) 1903 (Year)\nThe name of the ship or railroad on which I came was\nMy last place of foreign residence was Biale\nbalicia\n(City or town)\nwident\nt\nwife\nI am not married. The name or my\nj Bindic (Country)\nShe\nwag born at\nhusband\nHe\n,\nand now resides at\n,\nI am now a subject of and intend to renounce allegiance to\nPolared Russia\n(Write name and title of sovereign and country of which now a subject;\nif citizen of a write name of\nI or, arrived at the republic, United States republic immigration only) port of\n4.y\n(City or town)\nnew york (State n.y. or territory)\n, on June 14-8\n1903\n(Give exact month, day, and year)\n(OVER)"
}