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Page 970 of 1298
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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
The full name of the person shown on my steamship ticket was
My mother's maiden name was
Ma maiden name was (if woman)
My post-office address is
The ticket on which I came to this country was bought at
(City)
(Country)
1st cabin
If arrival by ship: Name of steamship line was
2d cabin
3d cabin
I arrived as (passenger, stowaway, seaman, member of crew, or otherwise)
(State which)
I traveled on (an immigr tion 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
At that time I intended to remain (permanently, temporarily, for visit, in transit)
(State which)
The person in the United States I was coming 6Q was
(Give name in full)
The place in the United States I was going to was
The names of some of the persons or passengers I traveledwwith were
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
(f) The place in
{
Canada
Mexico
where I bought my railroad ticket to come to the United States was
SVERNMENT PRENTING OFFICE 14-8
(OVER)
(Signature of applicant)
Page data
- Page
- 970
- Source index
- 0
- Type
- photo
- Media ID
- ea082a675135ad1d
- 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",
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"collections": [
"Naturalization Records of Non-Federal Courts in Connecticut",
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}
Context sent to Scholar
Document identity
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"label": "File numbers 4874 - 5509, 1926-1930",
"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",
"contentType": "document",
"title": "File numbers 4874 - 5509, 1926-1930",
"citationUrl": "https://catalog.archives.gov/id/159596813",
"collections": [
"Naturalization Records of Non-Federal Courts in Connecticut",
"Applications for Declaration of Intention"
],
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Document source extras
{
"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.",
"url": "https://www.familysearch.org/search/catalog/results?count=20&query=%2Bkeywords%3A4526886%20%2Bkeywords%3ANational%20%2Bkeywords%3AArchives"
}
],
"recordType": "description",
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Page context
{
"seq": 970,
"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_00970.jpg",
"mediaId": "ea082a675135ad1d",
"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\nThe full name of the person shown on my steamship ticket was\nMy mother's maiden name was\nMa maiden name was (if woman)\nMy post-office address is\nThe ticket on which I came to this country was bought at\n(City)\n(Country)\n1st cabin\nIf arrival by ship: Name of steamship line was\n2d cabin\n3d cabin\nI arrived as (passenger, stowaway, seaman, member of crew, or otherwise)\n(State which)\nI traveled on (an immigr tion 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)\n(Day)\n(Year)\nI. was examined by immigration officers at\nAt that time I intended to remain (permanently, temporarily, for visit, in transit)\n(State which)\nThe person in the United States I was coming 6Q was\n(Give name in full)\nThe place in the United States I was going to was\nThe names of some of the persons or passengers I traveledwwith were\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\n(f) The place in\n{\nCanada\nMexico\nwhere I bought my railroad ticket to come to the United States was\nSVERNMENT PRENTING OFFICE 14-8\n(OVER)\n(Signature of applicant)"
}