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Page 856 of 1298
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OCR
I have
used another name in this country than that given at the beginning of this form. If so, it was
I used that name because my family changed name to Rubin
Jacob Rubin
Huscard
The full name of the person shown on my steamship ticket was yankili Dubner
My mother's maiden name, was
Joba Weiner
My maiden name was (if woman)
My post-office address is Belanon, Ch.
The ticket on which I came to this country was bought at Hemberg (City) (Country) Girming
If
arrival by ship: Name of steamship line was Hemlynn amain
1st cabin
2d cabin
3d cabin
}
I arrived as (passenger, stowaway, seaman, member of crew, or otherwise) (State which)
previously
I traveled on (an immigration visa, a passport, a permit)
(State which)
I paid
head tax at
, on
(State amount)
(City)
(State or country)
(Month) (Day) (Year)
I was examined by immigration officers at
new your
At that time I intended to remain (permanently, temporarily, for visit, in transit)
Joreman
The person in the United States I was coming to was brother
(State which)
more Ruhin
(Give name in full)
The place in the United States I going was new york
was to
The names of some of the persons or passengers I traveled with were
Dont remember
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
GOVERNMENT PRINTING OFFICE 14-8
(OVER)
(Signature of applicant)
Page data
- Page
- 856
- Source index
- 0
- Type
- photo
- Media ID
- 75c6d836bbe87b50
- 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",
"citationUrl": "https://catalog.archives.gov/id/159596813",
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Context sent to Scholar
Document identity
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"core": "doc",
"dtoType": "document",
"citationUrl": "https://catalog.archives.gov/id/159596813"
}
Document source metadata
{
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"sourceUrl": "https://catalog.archives.gov/id/159596813",
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"citationUrl": "https://catalog.archives.gov/id/159596813",
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"Applications for Declaration of Intention"
],
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Document source extras
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"url": "https://catalog.archives.gov/id/159596813",
"naId": 159596813,
"levelOfDescription": "fileUnit",
"onlineResources": [
{
"description": "FamilySearch",
"note": "This file was scanned as part of a collaboration effort between FamilySearch and the National Archives.",
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],
"recordType": "description",
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Page context
{
"seq": 856,
"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_00856.jpg",
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"ocrText": "I have\nused another name in this country than that given at the beginning of this form. If so, it was\nI used that name because my family changed name to Rubin\nJacob Rubin\nHuscard\nThe full name of the person shown on my steamship ticket was yankili Dubner\nMy mother's maiden name, was\nJoba Weiner\nMy maiden name was (if woman)\nMy post-office address is Belanon, Ch.\nThe ticket on which I came to this country was bought at Hemberg (City) (Country) Girming\nIf\narrival by ship: Name of steamship line was Hemlynn amain\n1st cabin\n2d cabin\n3d cabin\n}\nI arrived as (passenger, stowaway, seaman, member of crew, or otherwise) (State which)\npreviously\nI traveled on (an immigration visa, a passport, a permit)\n(State which)\nI paid\nhead tax at\n, on\n(State amount)\n(City)\n(State or country)\n(Month) (Day) (Year)\nI was examined by immigration officers at\nnew your\nAt that time I intended to remain (permanently, temporarily, for visit, in transit)\nJoreman\nThe person in the United States I was coming to was brother\n(State which)\nmore Ruhin\n(Give name in full)\nThe place in the United States I going was new york\nwas to\nThe names of some of the persons or passengers I traveled with were\nDont remember\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)\n{\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\nGOVERNMENT PRINTING OFFICE 14-8\n(OVER)\n(Signature of applicant)"
}