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5254 Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 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 andy (Alien should Freeman print typewrite here true, original, Rolf and correct ; age, 4241 years. or name) (Give age last birthday) My present occupation is marine work. My personal description is: Color, white, complexion, Fair ; height, 3 feet 8/1 inches; weight, 1.52 pounds; color of hair, Brown ; color of eyes, B rown ; scars on middlefingers fingers /I was born in on right hand (City or town) theneree, Hants County (Country) Noua Ecotia other visible distinctive marks: left founinger and all on the the 10 day of 7 ebruary 1 887 , My present residence is 4 shiff street New Loondon, (City Connecticut (County) (State) Number and street) or town) The place where I took the ship or train which landed me in the United States was Hanto Port, Noualicotia to yarmouth noua 8 cotia on March th 20 19.19 was northland (Month) (Day) (Year) The name of the ship or railroad on which I came My last place of foreign residence said was Cheuerie Hants County. (Country) noua Scotia (City or town) wife is Grace Florence She Centre Buslington Noua Scotin and now sdid resides at/ cliff Start new hendon, Come I am yes married. The name of my husband was born at He I am now a subject of and intend to renounce allegiance to George V Write King nameand ofgreat thie of sovereign and Britain country of which of now breland a subject; I or, arrived if citizen at of the republic, United write States of republic immigration only) port of Boston Maesachusetts a name March the 20, 19.19 (City or town) , on (State or territory) 14-8 (Give exact month, day, and year) (OVER)

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758
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Document data

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Core
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Type
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    "ocrText": "5254\nForm 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\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\nandy (Alien should Freeman print typewrite here true, original, Rolf and correct\n; age,\n4241\nyears.\nor name)\n(Give age last birthday)\nMy present occupation is marine work.\nMy personal description is: Color, white, complexion, Fair\n;\nheight, 3 feet 8/1 inches;\nweight, 1.52 pounds; color of hair, Brown\n;\ncolor of eyes, B rown\n;\nscars on middlefingers\nfingers\n/I was born in on right hand (City or town) theneree, Hants County (Country) Noua Ecotia\nother visible distinctive marks: left founinger and all\non\nthe the 10 day of 7 ebruary\n1 887\n,\nMy present residence is 4 shiff street New Loondon, (City Connecticut (County) (State)\nNumber and street)\nor town)\nThe place where I took the ship or train which landed me in the United States was Hanto Port, Noualicotia\nto yarmouth noua 8 cotia on\nMarch\nth 20\n19.19\nwas northland (Month)\n(Day)\n(Year)\nThe name of the ship or railroad on which I came\nMy last place of foreign residence\nsaid was Cheuerie Hants County. (Country) noua Scotia\n(City or town)\nwife\nis Grace Florence\nShe\nCentre Buslington Noua Scotin and now sdid resides at/ cliff Start new hendon, Come\nI am yes married. The name of my husband\nwas born at\nHe\nI am now a subject of and intend to renounce allegiance to George V Write King nameand ofgreat thie of sovereign and Britain country of which of now breland a subject;\nI or, arrived if citizen at of the republic, United write States of republic immigration only) port of Boston Maesachusetts\na name\nMarch the 20, 19.19\n(City or town)\n, on\n(State or territory)\n14-8\n(Give exact month, day, and year)\n(OVER)"
}