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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5170
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
Allina
I desire to file my Declaration of Intention (first paper) to become a citizen.
Mr.
My name is
Mrs.
/
Mrs. MiTiAMA Beit
Miss
(Alien should print or typewrite here true, original, and correct name)
; age, 27 (Give age years last birthday) ImDrears.
My personal description is: Color, White ; complexion, daire
My present occupation is
Housewrife
; hgight, 5 feet 414 inches;
weight, 186 pounds; color of hair, BLACK
; color of eyes,
dark Brown
;
other visible distinctive marks: Scaron backofleft forefinger
I was born in
VilNA , RussiAnners Poland
on the 10th October
(City or town)
(Country)
day of
1900
My
present
residence
is
3 Stockwell PlAce Norwich New London Corn
(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 RotterdAm
HollAnd
, on MAY (Month) (Day)
14Th
1917
(Year)
The name of the ship or railroad on which I came was Noordan
My last
place of foreign said residence was INA Roland
(City or town)
(Country)
I am
married. The name of my
NAthAN Beit
She
is
husband
}
was born at
He
LAibiszKi, RussiA , and said now
resides at
3 Stockwell PIACE
I am now a subject of and intend to renounce allegiance to Rosin Paland
(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 at the United States immigration port of Ellis Island Newyork
(City or town)
New (State or territory)
York
, on (Give exact month, day, and
MAYJOH2 1917
year)
(OVER)
Page data
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- Source index
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- Type
- photo
- Media ID
- ad134924ca0524e3
- 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\n5170\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\nAllina\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMrs.\n/\nMrs. MiTiAMA Beit\nMiss\n(Alien should print or typewrite here true, original, and correct name)\n; age, 27 (Give age years last birthday) ImDrears.\nMy personal description is: Color, White ; complexion, daire\nMy present occupation is\nHousewrife\n; hgight, 5 feet 414 inches;\nweight, 186 pounds; color of hair, BLACK\n; color of eyes,\ndark Brown\n;\nother visible distinctive marks: Scaron backofleft forefinger\nI was born in\nVilNA , RussiAnners Poland\non the 10th October\n(City or town)\n(Country)\nday of\n1900\nMy\npresent\nresidence\nis\n3 Stockwell PlAce Norwich New London Corn\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 RotterdAm\nHollAnd\n, on MAY (Month) (Day)\n14Th\n1917\n(Year)\nThe name of the ship or railroad on which I came was Noordan\nMy last\nplace of foreign said residence was INA Roland\n(City or town)\n(Country)\nI am\nmarried. The name of my\nNAthAN Beit\nShe\nis\nhusband\n}\nwas born at\nHe\nLAibiszKi, RussiA , and said now\nresides at\n3 Stockwell PIACE\nI am now a subject of and intend to renounce allegiance to Rosin Paland\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 at the United States immigration port of Ellis Island Newyork\n(City or town)\nNew (State or territory)\nYork\n, on (Give exact month, day, and\nMAYJOH2 1917\nyear)\n(OVER)"
}