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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5246
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.
Mr.
My name is
Mrs.
Miss
/
Miss AGNES JESSIE HUGHES
; age,
26
years.
(Alien should print or typewrite here true, original, and correct name)
(Give age last birthday)
My present occupation is
Business Sucilary
My personal description is: Color, White complexion,
Fair
; height, 5 feet t inches;
weight, 98 pounds; color of hair, sigbrown ; color of eyes, Blue
;
other visible distinctive marks: none
I was born in
(City of town)
English
(Country)
on the 2nd day of June
My present residence
is SF (City Pawcatuck neulondon-Come. (County) (State)
47Liberty
golftomington
(Number and street)
or town)
The
place where I took the ship or train which landed me in the United States was
, on
July (Month) 2nd (Day) 1912 (Year)
The
name of the ship or railroad sand on which I came was S.S Cymbic
My last place of foreign residence was
Bolton
(City or town)
Syland
(Country)
am not married. The name of my wife
husband
}
She
I
is
was born at
He
, and now resides at
I am now a subject of and intend
to renounce allegiance to Wing (Write name Large and title of sovereign and country of of
which now a subject;
or, if citizen of a republic, write name of republic only)
England
I arrived at the United States immigration port of
Boston -
(City or town)
,
(State or territory)
on July 14-8, (Give 12-1912 exact month, day, and
year)
(OVER)
Page data
- Page
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- Source index
- 0
- Type
- photo
- Media ID
- cd77e5ed0c593ed0
- 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\n5246\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.\nMr.\nMy name is\nMrs.\nMiss\n/\nMiss AGNES JESSIE HUGHES\n; age,\n26\nyears.\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nMy present occupation is\nBusiness Sucilary\nMy personal description is: Color, White complexion,\nFair\n; height, 5 feet t inches;\nweight, 98 pounds; color of hair, sigbrown ; color of eyes, Blue\n;\nother visible distinctive marks: none\nI was born in\n(City of town)\nEnglish\n(Country)\non the 2nd day of June\nMy present residence\nis SF (City Pawcatuck neulondon-Come. (County) (State)\n47Liberty\ngolftomington\n(Number and street)\nor town)\nThe\nplace where I took the ship or train which landed me in the United States was\n, on\nJuly (Month) 2nd (Day) 1912 (Year)\nThe\nname of the ship or railroad sand on which I came was S.S Cymbic\nMy last place of foreign residence was\nBolton\n(City or town)\nSyland\n(Country)\nam not married. The name of my wife\nhusband\n}\nShe\nI\nis\nwas born at\nHe\n, and now resides at\nI am now a subject of and intend\nto renounce allegiance to Wing (Write name Large and title of sovereign and country of of\nwhich now a subject;\nor, if citizen of a republic, write name of republic only)\nEngland\nI arrived at the United States immigration port of\nBoston -\n(City or town)\n,\n(State or territory)\non July 14-8, (Give 12-1912 exact month, day, and\nyear)\n(OVER)"
}