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{
    "localId": "159596813",
    "label": "File numbers 4874 - 5509, 1926-1930",
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    "contentType": "document",
    "title": "File numbers 4874 - 5509, 1926-1930",
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    "collections": [
        "Naturalization Records of Non-Federal Courts in Connecticut",
        "Applications for Declaration of Intention"
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{
    "seq": 790,
    "pageIndex": 0,
    "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_00790.jpg",
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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5270\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 a\nfile my\nDeclaration nachemys of Intention (first paper) Ciegielnicki to /become citizen.\nMr.\n/ (Mathan (Alion-obould Shigh here original and\n24\nMy name is\nMrs.\n; age,\nyears.\nprint or twnwwite true correct name)\n(Give age last birthday)\nMy My present personal occupation Miss description is is: Color, any tribity ; complexion, merehants lightfair ; height, darkform. ST feet inches; 4\nweight,\n143\npounds;\ncolor of hair, Brown\n; color of eyes,\nother visible distinctive marks:\nA now\nI was born in Wilni, a Bunia, (Country) Poland\n(City or town)\non\nthe residence 13 is day of at hourich, Com\n1904\nMy\npresent\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\nRetterdam Holland\n, on may (Month)\n30,\n1917\n(Day)\n(Year)\nThe name of the ship or railroad on which I came was\nMordann\nMy last place of foreign\nresidence said was Williams Runid\n(City or town)\n(Country)\nI am no married. The name of my\n{\nwife\nShe\nis\n-\nhusband\n}\nwas born at\nHe\n, and now resides at\n,\nI am now a subject of and intend to renounce allegiance to\nPaland\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\nHolideneum (City Men town) Jerrey\nor\nnew Jack (State n.y or territory)\n, on\nmay 14-8 (Give 3 exact month, D day, 1987 and year)\n(OVER)"
}