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400 435
ORIGINAL
No. 436
437
ORIGINAL
the
STATES OF
STATES OF
of Commerce and Tabor
Department of and
BUREAU OF IMMIGRATION AND NATURALIZATION
BUREAU OF IMMIGRATION AND NATURALIZATION
R
DIVISION/ or NATURALIZATION
DIVISION or NATURALIZATION
DECLARATION OF INTENTION
DECLARATION OF INTENTION
(Invalid for all purposes seven years after the date hereof)
(Invalid for all purposes seven years after the date hereof)
In the
STATE OF CALTFORNIA)
SUPERIO: Court
STATE OF CALIFORNTA)
In the SUPERIOR
Court
SS:
County of Lostingsles
THE STATE or CALUFORNIA;
County of Los Angeles SS, of
- STATR OF CALIFORNIA,
Paprick of IN AND FOR Los
ARDÉLES
- AND FOR Les ANGELES COUNTY,
3,
aged ag years,
J,
aged
26 years,
Stardenal
do
declare on oath
that my personal
occupation
Plerk
occupation description is: Color White complexion Stan height feet inches,
do declare on oath that my personal
description
is: Color White complexion Damk affirm height feet inches,
weight 150 pounds, color of hair line 10am color of eyes
weight 155 pounds, color of hair I slack color of eyes filme
other visible distinctive marks
other visible distinctive marks
Nino
Animal
:
I.
was born in Montfords
on the 27 day of Describer
anno
Resperin
1
was born in Korna
on
the
25
,
day
of
Domini 1 86% I now reside at 856 (ach
august anno
emigrated United States of America from Decements Barland
Domini I 88th now reside at 60g Bannun AR Dr. Caugula Carla
I to the
I
emigrated to the United States of America from Healthy Sanuary
my last
on the vessel
on foreign the vessel residence was Woodfand :
Augusta Vistona
my last
foreign residence was
Kouna Russia
It is my bona fide, intention to renounce forever all allegiance and fidelity to any foreign
pringe, poténtate, and particularly of which I
state, or sovereignty
Centre
It is my bona fide intention to renounce forever all allégiance and fidelity to any foreign
of
citieen
am now a subject
1
prince (Impart portentate, state, or sovereignty and particularly to teaples of which I am now 11 a citizon
I
arrived at the port of
in the
arrived at the port of
about the 1/ day
New York
New Cynth
subject
New yours
in the
New your
State
State
of
on or
of
on or about the
District
5m day
District of March
1 anno Domini 596 I am not an anarchist: I am not a
of
augush : anno Domini 9037 I am not an anarchist: 1 am not a
polygamist nor a believer in the practice of polygamy: and it is my intention in good faith
polygamist nor a believer in the practice of polygamy: and it is my intention in good faith
to become a citizen of the United States of America and to permanently reside therein
to become a citizen of the United States of America and to permanently reside therein:
So HELP ME GOD.
patrich 1ilray
So HELP ME GOD.
Lous Rosenber
(Original algnature of declarant.)
Subscribed and sworn.to before me this
gm
(Original signature of declagant
Subscribed and sworn to before me this
[SEAL:]
day of
Emper anno Domini 19
[SEAL.]
day
of Must apne Domint 19
COUNT AND EX
CLEMO AND E
COUNT
By SUPERIOR ANGRI COURT Differency IN Clerk.
AUD CAL FOR THI the
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"ocrText": "400 435\nORIGINAL\nNo. 436\n437\nORIGINAL\nthe\nSTATES OF\nSTATES OF\nof Commerce and Tabor\nDepartment of and\nBUREAU OF IMMIGRATION AND NATURALIZATION\nBUREAU OF IMMIGRATION AND NATURALIZATION\nR\nDIVISION/ or NATURALIZATION\nDIVISION or NATURALIZATION\nDECLARATION OF INTENTION\nDECLARATION OF INTENTION\n(Invalid for all purposes seven years after the date hereof)\n(Invalid for all purposes seven years after the date hereof)\nIn the\nSTATE OF CALTFORNIA)\nSUPERIO: Court\nSTATE OF CALIFORNTA)\nIn the SUPERIOR\nCourt\nSS:\nCounty of Lostingsles\nTHE STATE or CALUFORNIA;\nCounty of Los Angeles SS, of\n- STATR OF CALIFORNIA,\nPaprick of IN AND FOR Los\nARDÉLES\n- AND FOR Les ANGELES COUNTY,\n3,\naged ag years,\nJ,\naged\n26 years,\nStardenal\ndo\ndeclare on oath\nthat my personal\noccupation\nPlerk\noccupation description is: Color White complexion Stan height feet inches,\ndo declare on oath that my personal\ndescription\nis: Color White complexion Damk affirm height feet inches,\nweight 150 pounds, color of hair line 10am color of eyes\nweight 155 pounds, color of hair I slack color of eyes filme\nother visible distinctive marks\nother visible distinctive marks\nNino\nAnimal\n:\nI.\nwas born in Montfords\non the 27 day of Describer\nanno\nResperin\n1\nwas born in Korna\non\nthe\n25\n,\nday\nof\nDomini 1 86% I now reside at 856 (ach\naugust anno\nemigrated United States of America from Decements Barland\nDomini I 88th now reside at 60g Bannun AR Dr. Caugula Carla\nI to the\nI\nemigrated to the United States of America from Healthy Sanuary\nmy last\non the vessel\non foreign the vessel residence was Woodfand :\nAugusta Vistona\nmy last\nforeign residence was\nKouna Russia\nIt is my bona fide, intention to renounce forever all allegiance and fidelity to any foreign\npringe, poténtate, and particularly of which I\nstate, or sovereignty\nCentre\nIt is my bona fide intention to renounce forever all allégiance and fidelity to any foreign\nof\ncitieen\nam now a subject\n1\nprince (Impart portentate, state, or sovereignty and particularly to teaples of which I am now 11 a citizon\nI\narrived at the port of\nin the\narrived at the port of\nabout the 1/ day\nNew York\nNew Cynth\nsubject\nNew yours\nin the\nNew your\nState\nState\nof\non or\nof\non or about the\nDistrict\n5m day\nDistrict of March\n1 anno Domini 596 I am not an anarchist: I am not a\nof\naugush : anno Domini 9037 I am not an anarchist: 1 am not a\npolygamist nor a believer in the practice of polygamy: and it is my intention in good faith\npolygamist nor a believer in the practice of polygamy: and it is my intention in good faith\nto become a citizen of the United States of America and to permanently reside therein\nto become a citizen of the United States of America and to permanently reside therein:\nSo HELP ME GOD.\npatrich 1ilray\nSo HELP ME GOD.\nLous Rosenber\n(Original algnature of declarant.)\nSubscribed and sworn.to before me this\ngm\n(Original signature of declagant\nSubscribed and sworn to before me this\n[SEAL:]\nday of\nEmper anno Domini 19\n[SEAL.]\nday\nof Must apne Domint 19\nCOUNT AND EX\nCLEMO AND E\nCOUNT\nBy SUPERIOR ANGRI COURT Differency IN Clerk.\nAUD CAL FOR THI the"
}