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I have yes
used another name in this country than that given at the beginning of this form. If so, it was
Ruth Lea (Rochil) Surman
I used that name because
l
was not married
The full of the shown steamship ticket Rochil Turmsh
name person on my was
My mother's maiden
name was Rose Lak
My maiden name was (if woman)
Rachil Tudman
My post-office address is
55 Summer aud st. new London Come
10
"NOISOS
The ticket on which I came to this country was bought at
Glaunas
Lithnanie
are
(City)
(Country)
If arrival Name of line was Stensee amer Line 2d
2761 66,270
1st cabin
by ship: steamship
cabin
3d cabin-
}
TIATUANY
BOTABRS
I arrived as (passenger, stowaway, seaman, member of crew, or otherwise)
I traveled on (an immigration visa, a passport, a permit)
passport
parsinger (State which)
(State which)
I paid
head tax at
, on
(State amount)
(City)
(State or country)
(Month)
(Day)
(Year)
I was examined by immigration officers at
At that time I intended
The in the United I
person was to was
to States remain (permanently, coming temporarily, Semuel for visit, in transit) Uniman (Give name in full) (State which)
The place in the United States I was going to was springfield mass.
The names of some of the persons or passengers I traveled with were
ADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME From OR THROUGH CANADA OR MEXICO:
(a) The place in Canada where I landed was
, on
(Month)
(Day)
(Year)
Canada
(b) The place in
from which I entered the United States was
Mexico
(c) On
(Month)
(Day)
(Year)
(d) The place where I was examined for admission at the United States border was
(e) If not examined, state why, and give the circumstances of your entry
Canada
(f) The place in
Mexico
where I bought my railroad ticket to come to the United States was
Ruth Lea Hendel
GOVERNMENT PRENTING OFFICE 14-8
(OVER)
(Signature of applicant)
Page data
- Page
- 731
- Source index
- 0
- Type
- photo
- Media ID
- f33b11eb9545ba8a
- Size
- unknown
Document data
- ID
- 159596813
- Core
- doc
- Type
- document
DTO data
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"contentType": "document",
"title": "File numbers 4874 - 5509, 1926-1930",
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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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"type": "photo",
"url": "https://s3.amazonaws.com/NARAprodstorage/lz/partnerships-0002/18-0177_US-MA/18-0177_US-MA_21/18-0177_US-MA_-4526886-CTN-Applications-for-Declaration-of--1926-1930/18-0177_US-MA_-4526886-CTN-Applications-for-Declaration-of--1926-1930_00731.jpg",
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"ocrText": "I have yes\nused another name in this country than that given at the beginning of this form. If so, it was\nRuth Lea (Rochil) Surman\nI used that name because\nl\nwas not married\nThe full of the shown steamship ticket Rochil Turmsh\nname person on my was\nMy mother's maiden\nname was Rose Lak\nMy maiden name was (if woman)\nRachil Tudman\nMy post-office address is\n55 Summer aud st. new London Come\n10\n\"NOISOS\nThe ticket on which I came to this country was bought at\nGlaunas\nLithnanie\nare\n(City)\n(Country)\nIf arrival Name of line was Stensee amer Line 2d\n2761 66,270\n1st cabin\nby ship: steamship\ncabin\n3d cabin-\n}\nTIATUANY\nBOTABRS\nI arrived as (passenger, stowaway, seaman, member of crew, or otherwise)\nI traveled on (an immigration visa, a passport, a permit)\npassport\nparsinger (State which)\n(State which)\nI paid\nhead tax at\n, on\n(State amount)\n(City)\n(State or country)\n(Month)\n(Day)\n(Year)\nI was examined by immigration officers at\nAt that time I intended\nThe in the United I\nperson was to was\nto States remain (permanently, coming temporarily, Semuel for visit, in transit) Uniman (Give name in full) (State which)\nThe place in the United States I was going to was springfield mass.\nThe names of some of the persons or passengers I traveled with were\nADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME From OR THROUGH CANADA OR MEXICO:\n(a) The place in Canada where I landed was\n, on\n(Month)\n(Day)\n(Year)\nCanada\n(b) The place in\nfrom which I entered the United States was\nMexico\n(c) On\n(Month)\n(Day)\n(Year)\n(d) The place where I was examined for admission at the United States border was\n(e) If not examined, state why, and give the circumstances of your entry\nCanada\n(f) The place in\nMexico\nwhere I bought my railroad ticket to come to the United States was\nRuth Lea Hendel\nGOVERNMENT PRENTING OFFICE 14-8\n(OVER)\n(Signature of applicant)"
}