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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5329
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 of Intention (first paper) to become a citizen.
Mr.
My name is
Mrs.
HERMINA CORMIER
; age,
45
years.
Miss-
(Alien should print or typewrite here true, original, and correct name)
(Give age last birthday)
My present occupation is
My personal description is: Color, White ; complexion, medium fair height, 5 feet 3 inches;
Housewife
23/4
weight, 130 pounds; color of hair, Black
; color of
other visible distinctive marks: Small rearnaturat
eyes, grey Brown
I was born in
It Brandonn, Canada
Damien,
(City or town)
(Country)
on the 21
day of
, 18823
Griswood
My present residence is 2223 (Number and street) Jewett (City or town) City A new (County) London (State) Conn
Carely
The place where I took the ship or train which landed me in the United States was
It yabriel
Canada
, on December 8 1890
(Month)
(Day)
(Year)
The name of the ship or railroad on which I came was
Canadirn Pacific Pailand
My last place of foreign residence
sand was St Damien Brandom Carreda
(City or town)
(Country)
wife
is
husband
Ephrises Corner
She
I am
married. The name of my
}
was born at
He
Royton Pond Canada and now resides
at Canada 23 Carely are gunetticity
I am now a subject of and intend to renounce allegiance to
(Write name and title of sovereign and country of which now a subject;
of republic, write name of republié Vita only)
or, if citizen a
I arrived at the United States immigration port of
Faftvillest
albans, Vt,
(City or town)
Connecticut
, on
(State or territory)
Dec 14-8 (Give exact 9 month, 1890 day /and
year)
(OVER)
Page data
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- Source index
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- Type
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- Media ID
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Document data
- ID
- 159596813
- Core
- doc
- Type
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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\n5329\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 of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMrs.\nHERMINA CORMIER\n; age,\n45\nyears.\nMiss-\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nMy present occupation is\nMy personal description is: Color, White ; complexion, medium fair height, 5 feet 3 inches;\nHousewife\n23/4\nweight, 130 pounds; color of hair, Black\n; color of\nother visible distinctive marks: Small rearnaturat\neyes, grey Brown\nI was born in\nIt Brandonn, Canada\nDamien,\n(City or town)\n(Country)\non the 21\nday of\n, 18823\nGriswood\nMy present residence is 2223 (Number and street) Jewett (City or town) City A new (County) London (State) Conn\nCarely\nThe place where I took the ship or train which landed me in the United States was\nIt yabriel\nCanada\n, on December 8 1890\n(Month)\n(Day)\n(Year)\nThe name of the ship or railroad on which I came was\nCanadirn Pacific Pailand\nMy last place of foreign residence\nsand was St Damien Brandom Carreda\n(City or town)\n(Country)\nwife\nis\nhusband\nEphrises Corner\nShe\nI am\nmarried. The name of my\n}\nwas born at\nHe\nRoyton Pond Canada and now resides\nat Canada 23 Carely are gunetticity\nI am now a subject of and intend to renounce allegiance to\n(Write name and title of sovereign and country of which now a subject;\nof republic, write name of republié Vita only)\nor, if citizen a\nI arrived at the United States immigration port of\nFaftvillest\nalbans, Vt,\n(City or town)\nConnecticut\n, on\n(State or territory)\nDec 14-8 (Give exact 9 month, 1890 day /and\nyear)\n(OVER)"
}