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Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 5195 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 I desire to file my Declaration of Intention (first paper) to become a citizen. Mc. My name is Mas. Three Anna Gentrude Blue ; age, 27 years. Miss (Alien should print or typewrite here true, original, and correct name) (Give age last birthday) My present occupation is nursing Y2 My personal description is: Color, White: complexion, fair Y ; height, 5 feet 6 inches; weight, 140 pounds; color of hair. Light Brown ; color of eyes, Blue ; other visible distinctive marks: Scarmileft sideofnuck I was born in Valley mills, Houa Scotia (City or town) (Country) 16th day of crestory on the December 1899 norwich, My present residence is Horwich State Hospital Harwich, newLondon, Connecticut forthyunanc, (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 Rivey Dennis, station Novascotia on October 18 1917 (Month) (Day) (Year) The name of the ship or railroad on whick I came was Intercolonical Railway My last place of foreign residence was Valley mills Have Sectia sand (City or town) (Country) of She I am not married. The name of my whe is was horn at husband He , and now resides at , I subject of and intend allegiance to King Georget of Great Britain am now a to renounce (Write name and title of sovereign and country of which now a subject; or, if citizen of a republic, write name of republic only) Vanceboro maine I arrived at the United States immigration port of St John new Brunsweek (City or town) Canader , on Oct. 18, 1917 (State or territory) 14-8 (Give exact month, day, and year) (OVER)

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643
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Document data

ID
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Core
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Type
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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5195\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\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMc.\nMy name is\nMas.\nThree Anna Gentrude Blue\n; age,\n27\nyears.\nMiss\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nMy present occupation is\nnursing\nY2\nMy personal description is: Color, White: complexion, fair Y\n; height, 5 feet\n6 inches;\nweight, 140 pounds; color of hair. Light Brown ; color of eyes, Blue\n;\nother visible distinctive marks: Scarmileft sideofnuck\nI was born in\nValley mills, Houa Scotia\n(City or town)\n(Country)\n16th day of\ncrestory\non\nthe\nDecember\n1899\nnorwich,\nMy present residence is Horwich State Hospital Harwich, newLondon, Connecticut\nforthyunanc,\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 Rivey Dennis, station\nNovascotia\non October\n18\n1917\n(Month)\n(Day)\n(Year)\nThe name of the ship or\nrailroad on whick I came was Intercolonical Railway\nMy last place\nof foreign residence was Valley mills Have Sectia\nsand\n(City or town)\n(Country)\nof\nShe\nI am not married. The name of my\nwhe\nis\nwas horn at\nhusband\nHe\n, and now resides at\n,\nI subject of and intend allegiance to King Georget of Great Britain\nam now a to renounce\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)\nVanceboro maine\nI arrived at the United States immigration port of\nSt John new Brunsweek\n(City or town)\nCanader\n, on\nOct. 18, 1917\n(State or territory)\n14-8\n(Give exact month, day, and year)\n(OVER)"
}