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Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 5302 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 CARD INDEX upper left-hand corner of all copies of declaration, immediately under your INDEX BOOKS declaration number. DISTRICT DIRECTOR OF NATURALIZATION MANIFESTS I desire to file my Declaration to a citizen. My name is Mrs. yankel (Alien Hankel should print typewrite here true, original, and correct name) of Intention (first Rubin paper) become Mr. / Rubin age, 39 years. or (Give age last birthday) My present occupation Miss is 59 farmer My personal description is: Color, white complexion, dark ; height, 5 feet 244 inches; weight, 140 color of hair, black ; color of eyes, brown pounds; other visible distinctive marks: Scarswnder chin andon left thumb I was born in Uesoka Russia (Country) (Now Belland on the 5 (City or town) day of sember 1888 My present residence is Letanor newford CL, (Number and street) (City or town) The place where I took the ship or train which landed me in the United States was Hamburg (County) (State) sermany on about Due 16 1905 The name or on came of the ship railroad said which I was Graf Waldeview (Month) (Day) (Year) My last place of foreign residence was Venaka (City or town) I am married. The name of my { wife husband } is 10 , Doba Country) She was born at said Rust 1 , and now said resides at Eugaron, 11, He I am now a subject of and intend to renounce allegiance to Polland twas Person Write name and title of sovereign and country of which now a subject; or, if citizen of a republic, write name of republic only) I arrived at the United States immigration port of new york York (City or town) new territory) , on Dec 30 1905 (State or 14-8 (Give exact month, day, and year) (OVER)

Page data

Page
855
Source index
0
Type
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Media ID
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Size
unknown

Document data

ID
159596813
Core
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Type
document
DTO data
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Context sent to Scholar

Document identity
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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5302\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\nCARD INDEX\nupper left-hand corner of all copies of\ndeclaration, immediately under your\nINDEX BOOKS\ndeclaration number.\nDISTRICT DIRECTOR OF NATURALIZATION\nMANIFESTS\nI desire to file my Declaration to a citizen.\nMy name is\nMrs.\nyankel (Alien Hankel should print typewrite here true, original, and correct name)\nof Intention (first Rubin paper) become\nMr.\n/\nRubin\nage,\n39\nyears.\nor\n(Give age last birthday)\nMy present occupation Miss is 59 farmer\nMy personal description is: Color, white complexion, dark\n; height, 5 feet 244 inches;\nweight, 140 color of hair, black ; color of eyes, brown\npounds;\nother visible distinctive marks: Scarswnder chin andon left thumb\nI was born in\nUesoka\nRussia (Country) (Now Belland\non the\n5\n(City or town)\nday of\nsember\n1888\nMy present residence is\nLetanor newford CL,\n(Number and street)\n(City or town)\nThe place where I took the ship or train which landed me in the United States was\nHamburg\n(County)\n(State)\nsermany\non\nabout Due\n16\n1905\nThe name or on came\nof the ship railroad said which I was Graf Waldeview (Month) (Day) (Year)\nMy last place of foreign residence was Venaka\n(City or town)\nI am\nmarried. The name of my\n{\nwife\nhusband\n}\nis\n10 , Doba Country)\nShe\nwas born at\nsaid\nRust\n1\n, and now\nsaid resides at Eugaron, 11, He\nI am now a subject of and intend to renounce allegiance to Polland twas Person\nWrite 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\nnew york\nYork\n(City or town)\nnew territory)\n, on\nDec 30 1905\n(State or\n14-8\n(Give exact month, day, and year)\n(OVER)"
}