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Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 5314 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 45021 in CARD INDEX 736-108-25 upper left-hand corner of all copies of declaration, immediately under your INDEX BOOKS declaration number. NATURA) DISTRIOT DIRECT OR OF NATURALIZATION MANIFESTS Daigle MAR 12 1929 I desire to file my Declaration of Intention (first paper) to become a citizen@ffice OF EXAMINER 47 Mr. My name is Maxime Charles Donote pown Mrs. , age, years. (Alien should print or typewrite here true, original, and correct name) (Give age last birthday) My present occupation Miss is Shoe-cutter 33/4 My personal description is: Color, White ; complexion, fair ; height, 5 feet X inches; weight, 127 pounds; color of hair, light brown ; color eyes, blue of ; other visible distinctive marks: bald I was born in St. Anlest,Canada Rult (City or town) (Country) on the third day of november , 1880 My present residence is 33 (Number and street) st (City town) N.L. (County) Came (State) Spring narcials, or The place where I took the ship or train which landed me in the United States was Sherbradez Canada , on sept, (Month) 10 T 1924 (Day) (Year) The name of the ship or railroad on which/I came was said Boston +maine Railroad My last place of foreign residence was A Sherbrooke Clear (City or town) (Country) wife I am married. The name of my is husband canada said alemina Berguon the She } was born at stoper Cunter, and now resides at 33 spring IN , I am now a subject of and intend to renounce allegiance to English (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 (City town) yours Buslington or Newport, Vermont (State territory) , on left 14-8 (Give 10 month, day, 1924 and year) or exact (OVER)

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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5314\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 45021 in\nCARD INDEX 736-108-25\nupper left-hand corner of all copies of\ndeclaration, immediately under your\nINDEX BOOKS\ndeclaration number.\nNATURA)\nDISTRIOT DIRECT OR OF NATURALIZATION\nMANIFESTS\nDaigle\nMAR 12 1929\nI desire to file my Declaration of Intention (first paper) to become a citizen@ffice OF EXAMINER\n47\nMr.\nMy name is\nMaxime Charles Donote\npown\nMrs.\n, age,\nyears.\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nMy\npresent occupation Miss is Shoe-cutter\n33/4\nMy personal description is: Color, White ; complexion, fair\n; height, 5 feet X inches;\nweight, 127 pounds; color of hair, light brown ; color eyes, blue\nof\n;\nother visible distinctive marks: bald\nI\nwas born in St. Anlest,Canada\nRult\n(City or town)\n(Country)\non the third day of november\n, 1880\nMy present residence is\n33 (Number and street) st (City town) N.L. (County) Came (State)\nSpring\nnarcials,\nor\nThe place where I took the ship or train which landed me in the United States was Sherbradez\nCanada\n, on sept, (Month)\n10 T 1924\n(Day)\n(Year)\nThe name of the ship or railroad on which/I came was\nsaid\nBoston +maine Railroad\nMy last place of foreign residence was\nA\nSherbrooke\nClear\n(City or town)\n(Country)\nwife\nI am\nmarried. The name of my\nis\nhusband canada said\nalemina Berguon the She\n}\nwas born at\nstoper Cunter, and now resides at 33 spring IN ,\nI am now a subject of and intend to renounce allegiance to\nEnglish\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\nStates immigration port of (City town) yours\nBuslington\nor\nNewport, Vermont (State territory)\n, on\nleft 14-8 (Give 10 month, day, 1924 and year)\nor\nexact\n(OVER)"
}