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No. 4/81
76377
ORIGINAL
No. 484
ORIGINAL
STATES OF
STATES OF
Department nf Commerce and Tabor
Depurtment of Commerce and
BUREAU OF IMMIGRATION AND NATURALIZATION
BUREAU OF IMMIGRATION AND NATURALIZATION
DIVISION OF NATURALIZATION
DIVISION OF 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)
STATE OF CALTFORNIA
In the
SUPERIOR Court
STITE of CALIFORNIA
In the
SUPERIOR Court
SS :
ss:
County of Los Angeles
Victime Jan Kin of
of Los Angates
THE STATE or
Spridone Derta of
THR STATE DE
- AND FOR Lee ANGELES
Ano FOR Lee ANGELge
3.
aged 32 years,
3.
aged 36 years,
famon
do
declare on oath
affirnt that my personal
Sailor
declare on oath
occupation
.description
occupation is: Color White complexion DEAR do raffirm height my
that personal
description is: Color White complexion gark height 3 feet inches,
weight 144 pounds, color of hair A Grey color of eyes Steu
weight color of hair Black color of eyes Brown
other visible distinctive marks dear on lefthand
: I was born in Clallage
other visible distinctive marks Male on left Chequ
anno
Portugal
:
I
was born in
Thanger on the W day of Jane
on
the
PO day of December anno
Domini 833 I now reside at Hai Eachange Sagar
Domini I 8% now reside at Palka
Memmyh
I emigrated to the United States of America from Harm Strance
I
emigrated to the United States of Amarica from Rafth Mega
on the vessel
C/A
Champane
my last
on the vessel *
Vega
last
foreign
residence was Gallagos Strance
foreign
residence was Gengin my
It is bona fide intention to renounce forever all allegiance and fidelity to any foreign
It
is my bona fide intention to renounce forever all allegiance and fidelity to any foreign
prince Shana my potentate, state, or sovereignty, and particularly to
prince, or
of which 1 am now a citizen
potentate state, sovereignty and particularly to of y
1
sebject
which 1 am now a eitigon subject
1
arrived
at the port of New
in the
arrived at the port of
State
Territery of
New York
chaw york
in the
Stite
New york on or about the 16
day
Tessitosy of
on or about the 100 day
of
Dietrict November anno Domini 589 I am not an anarchist: 1 am not
a
of District at July
anno Domini I 891 1 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
polygamiet 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.
zysdore Berde
So HELP ME GOD.
(Original signature di
3
(Original signatere of declarant.)
Subscribed and sworn.to before me this
Subscribed and
36
[SEAL.]
day of
anno Domini 1942
[SEAL.]
day of
Wex Defore me anno this Domini, 19 of
AMD.
ARD
ED
ORTIGIO
Court-
Clerk.
Clerk.
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"ocrText": "1\n18%\nNo. 4/81\n76377\nORIGINAL\nNo. 484\nORIGINAL\nSTATES OF\nSTATES OF\nDepartment nf Commerce and Tabor\nDepurtment of Commerce and\nBUREAU OF IMMIGRATION AND NATURALIZATION\nBUREAU OF IMMIGRATION AND NATURALIZATION\nDIVISION OF NATURALIZATION\nDIVISION OF 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)\nSTATE OF CALTFORNIA\nIn the\nSUPERIOR Court\nSTITE of CALIFORNIA\nIn the\nSUPERIOR Court\nSS :\nss:\nCounty of Los Angeles\nVictime Jan Kin of\nof Los Angates\nTHE STATE or\nSpridone Derta of\nTHR STATE DE\n- AND FOR Lee ANGELES\nAno FOR Lee ANGELge\n3.\naged 32 years,\n3.\naged 36 years,\nfamon\ndo\ndeclare on oath\naffirnt that my personal\nSailor\ndeclare on oath\noccupation\n.description\noccupation is: Color White complexion DEAR do raffirm height my\nthat personal\ndescription is: Color White complexion gark height 3 feet inches,\nweight 144 pounds, color of hair A Grey color of eyes Steu\nweight color of hair Black color of eyes Brown\nother visible distinctive marks dear on lefthand\n: I was born in Clallage\nother visible distinctive marks Male on left Chequ\nanno\nPortugal\n:\nI\nwas born in\nThanger on the W day of Jane\non\nthe\nPO day of December anno\nDomini 833 I now reside at Hai Eachange Sagar\nDomini I 8% now reside at Palka\nMemmyh\nI emigrated to the United States of America from Harm Strance\nI\nemigrated to the United States of Amarica from Rafth Mega\non the vessel\nC/A\nChampane\nmy last\non the vessel *\nVega\nlast\nforeign\nresidence was Gallagos Strance\nforeign\nresidence was Gengin my\nIt is bona fide intention to renounce forever all allegiance and fidelity to any foreign\nIt\nis my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nprince Shana my potentate, state, or sovereignty, and particularly to\nprince, or\nof which 1 am now a citizen\npotentate state, sovereignty and particularly to of y\n1\nsebject\nwhich 1 am now a eitigon subject\n1\narrived\nat the port of New\nin the\narrived at the port of\nState\nTerritery of\nNew York\nchaw york\nin the\nStite\nNew york on or about the 16\nday\nTessitosy of\non or about the 100 day\nof\nDietrict November anno Domini 589 I am not an anarchist: 1 am not\na\nof District at July\nanno Domini I 891 1 am not an anarchist: 1 am not\na\npolygamist nor a believer in the practice of polygamy and it is my intention in good faith\npolygamiet 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.\nzysdore Berde\nSo HELP ME GOD.\n(Original signature di\n3\n(Original signatere of declarant.)\nSubscribed and sworn.to before me this\nSubscribed and\n36\n[SEAL.]\nday of\nanno Domini 1942\n[SEAL.]\nday of\nWex Defore me anno this Domini, 19 of\nAMD.\nARD\nED\nORTIGIO\nCourt-\nClerk.\nClerk."
}