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184 No. 682, ORIGINAL No. 683 185 ORIGINAL STATES OF STATE of Department of Conunerce and Kabur Department of and Kabür 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 *ta in the SUPERIOR Court on cae the In the SS: County of Los Angeles SS: SUPERIOR Court County of 400 yeses of que STATE or GALIPORNIA, IN ANA FOR Les Louis ase Ottone of Jones The STATE or CALIPORNIA IN AND FOR Les COUNTY) 3. Charlotte Anne Rose aged 49 years, 3. , aged 36 years, occupation Stenoyrapher do declare affirm on oath that my personal occupation Juarler do declare affirm on oath that my personal description is: Color white complexion Dark height 5 feet 5 inches, description is: Color White complexion Flind height Leet inches, weight 130. pounds, color of hair Black color of eyes Brown weight 146 pounds, color of hair Brown color of eyes Brown other visible distinctive marks none other visible distinctive marks None : I was born in nombardy to : I was, ,born in Genera Canada , on the 17th day of saph. , anno Domini I 8651 now reside at 625 Pulm are So Pasabuy balifa Sanitzaland on the 28 day of Ock anno Domini I 871 I now reside at 7661/8 Tound are Pal I emigrated to the United States of America from Hindson Canada on the vesse) Grand Trunk a R I emigrated to the United States of America from Hanne Strance : my last on the vessel La Gratanne : my last foreign residence was It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign Smith Falls Anada foreign residence was years Smitzoland It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign prince, potentate, state, or sovereignty, and particularly to Egmard VII prince, potentate, state, or sovereignty, and particularly to of King of Greas Aritain Dibroit tousland , of which I am now a subject sitizen I arrived at the port of in the arrived at the port of Newyork of which I am now a citizen subject I in the State Territory of michigan on or about the 186 State day Ferritory of District District New youg off or about the 10a day of October anno Domini I 886 I. am not an anarchist; 1 am not a of September anno Domini 905 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. Charloctr anne EN Rose So HELP ME GOD. (Original signature of declarant.) pini Clouis fules lettone signature of declurant.) Subscribed and sworn affirmed to before me this 23rd Subscribed and afficiped sworn to before me this 23 [SEAL. ] day of March anno Domini 19 of [SEAL.] day of March anno Domini 19 08 - : AND EX- OFZICIO OLENC ow Clark of Coo ANDELER, COURY ETATE IN AND OF FOA THE Court. DOWNTY QLERK AND EN OFFICIO CLENKCOF Clerk. By of Clerk the SUPERIOR COUNT IN AI D FOT THE OQUNTY Court. tos ANDECER; STAXE OF By Clerk.

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    "ocrText": "184\nNo. 682,\nORIGINAL\nNo. 683\n185\nORIGINAL\nSTATES OF\nSTATE of\nDepartment of Conunerce and Kabur\nDepartment of and Kabür\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\n*ta\nin the SUPERIOR\nCourt\non cae the\nIn the\nSS:\nCounty of Los Angeles\nSS:\nSUPERIOR Court\nCounty of 400 yeses\nof\nque STATE or GALIPORNIA,\nIN ANA FOR Les\nLouis ase Ottone of\nJones\nThe STATE or CALIPORNIA\nIN AND FOR Les COUNTY)\n3. Charlotte Anne Rose\naged\n49 years,\n3.\n, aged\n36 years,\noccupation Stenoyrapher\ndo declare affirm on oath that my personal\noccupation\nJuarler\ndo declare affirm on oath that my personal\ndescription\nis: Color white complexion Dark height 5 feet 5 inches,\ndescription is: Color White complexion Flind height Leet inches,\nweight 130. pounds, color of hair Black color of eyes\nBrown\nweight 146 pounds, color of hair Brown color of eyes Brown\nother visible distinctive marks\nnone\nother visible distinctive marks\nNone\n:\nI was born in nombardy to\n:\nI was, ,born in Genera\nCanada\n, on the\n17th day of\nsaph.\n, anno\nDomini I 8651 now reside at 625 Pulm are So Pasabuy balifa\nSanitzaland on the 28 day of Ock\nanno\nDomini I 871 I now reside at 7661/8 Tound are Pal\nI\nemigrated to the United States of America from Hindson Canada\non the vesse) Grand Trunk a R\nI emigrated to the United States of America from Hanne Strance\n: my last\non the vessel\nLa Gratanne\n: my last\nforeign residence was\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nSmith Falls Anada\nforeign residence was years Smitzoland\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nprince, potentate, state, or sovereignty, and particularly to Egmard VII\nprince, potentate, state, or sovereignty, and particularly to of\nKing of Greas Aritain Dibroit tousland\n, of which I am now a subject\nsitizen\nI\narrived at the port of\nin the\narrived at the port of\nNewyork\nof which I am now a citizen subject I\nin the\nState\nTerritory of\nmichigan\non or about the\n186\nState\nday\nFerritory of\nDistrict\nDistrict\nNew youg\noff or about the 10a day\nof October\nanno Domini I 886 I. am not an anarchist; 1 am not a\nof September\nanno Domini 905 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.\nCharloctr anne EN Rose\nSo HELP ME GOD.\n(Original signature of declarant.)\npini\nClouis fules lettone\nsignature of declurant.)\nSubscribed and sworn affirmed to before me this\n23rd\nSubscribed and afficiped sworn to before me this 23\n[SEAL. ]\nday of March\nanno Domini 19 of\n[SEAL.]\nday of March anno Domini 19 08\n- : AND EX- OFZICIO OLENC ow\nClark of Coo ANDELER, COURY ETATE IN AND OF FOA THE Court.\nDOWNTY QLERK AND EN OFFICIO CLENKCOF\nClerk.\nBy of\nClerk the SUPERIOR COUNT IN AI D FOT THE OQUNTY Court.\ntos ANDECER; STAXE OF\nBy\nClerk."
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