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378
175
ORIGINAL
No. 876
STATES OF
STATES OF
Bepartment of Conmerte aud Gubur
Department of Canumerce and Tuabur
BUREAU OF IMMIGRATION AND NATURALIZATION
BUREAU OF IMMIGRATION AND NATURALIZATION
DIVISION OF NATURALIZATION
DIVISION OF NATURALIZATION
DECLARATION OF INTENTION
DECLARATION IFINTENTION
(Invalid for all purposes seven years after the date hereof)
(Invalid for all purposes seven years after the date hereof)
In the SUPERIOR Court
STATE OF CALTFORNTA)
In the SUPERUTE
SS:
Court
THE STATE OF CALIFORNIA,
SS:
County of Los dingeles
of
LAND FOR Lee COUNTY,
County of LOS Aiggetes
THE STATE OF CAL
of
CE Loe COUNTY,
3.
Hallace Linday Juffley
aged 52 years,
3,
Solomon mic Donald
aged 38 years,
occupation
Salesman
do declare affiem on oath that my personal
occupation
Contractor
do declare affirm on oath that my personal
description is: Color White complexion Fair height 5 feet 3/2inches,
description is: Color White
complexion Dank height 5 feet/d'inches,
weight 169 pounds, color of hair
Grey
color of eyes They
weight 160 pounds, color of hair Dark color of eyes Grey
other visible distinctive marks
none
other visible distinctive marks
none
:
I was born in Buntridge
was born in Charlotteta.
England on the 2nd day of June
, anno
Cauada
on the
8th
day of
Sept
anno
Domini I 856 1 now reside at 1012 Temple st Los Gingales bal
Domini I 869 I now reside at 13thCist Santa monica bat
I emigrated to the United States of America from antwerp Belzium
I emigrated to the United States of America from Winnergag Canada
on the vessel Rordland
my last
on
the vessel Northern Pacific RR
my last
foreign residence
was Beintridge England
foreign
residence was J Himsing Canada
It is my 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, potentate, state, or sovereignty, and particularly to Edward VII
prince, potentate, state, or sovereignty, and particularly to Edward VII
King of Great Britian a Incland of which I am now a subject eitizen
I
King of Gread Britian & Ireland of which I am now a subject citizen
I
arrived at
State the port of new york
to
thon
in the
arrived at the port of
XX Vincent
to nuo oil in the
5th
State
of
new york
on or about the
day
of
Disteict
Bistriet
north Dakoda 25 on or about the
24th day
of gune
anno Domini I 896 I am not an anarchist; 1 am not a
of
Dec
anno Domini I 905-1 am not an anarchist; I 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 fáith
to become a citizen of the United States of America and to permanently reside therein:
to become a citizen of the United States of Ametica and to permanently reside therein:
ME
Wallace Leily Capples
So HELP
ME GOD. Solanan Mad characted HAL
(Original signature of declarant.)
as
(Original signature or declarant.)
Subscribed and sworn to before me this 17th
des
ztrit
this
Subscribed and sworn to before me this 17th
[SEAL.]
day gune
, anno Domini 19
SEAL.] injoso onina
day of give
anno Domini igar
0.G. Keyes
C. G. Keges
COUNTY ARD
s
Clerk of Court.
By Administer Deputy OF
Clerk of
Court.
Clerk.
Desuty Clerk.
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Document data
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"ocrText": "378\n175\nORIGINAL\nNo. 876\nSTATES OF\nSTATES OF\nBepartment of Conmerte aud Gubur\nDepartment of Canumerce and Tuabur\nBUREAU OF IMMIGRATION AND NATURALIZATION\nBUREAU OF IMMIGRATION AND NATURALIZATION\nDIVISION OF NATURALIZATION\nDIVISION OF NATURALIZATION\nDECLARATION OF INTENTION\nDECLARATION IFINTENTION\n(Invalid for all purposes seven years after the date hereof)\n(Invalid for all purposes seven years after the date hereof)\nIn the SUPERIOR Court\nSTATE OF CALTFORNTA)\nIn the SUPERUTE\nSS:\nCourt\nTHE STATE OF CALIFORNIA,\nSS:\nCounty of Los dingeles\nof\nLAND FOR Lee COUNTY,\nCounty of LOS Aiggetes\nTHE STATE OF CAL\nof\nCE Loe COUNTY,\n3.\nHallace Linday Juffley\naged 52 years,\n3,\nSolomon mic Donald\naged 38 years,\noccupation\nSalesman\ndo declare affiem on oath that my personal\noccupation\nContractor\ndo declare affirm on oath that my personal\ndescription is: Color White complexion Fair height 5 feet 3/2inches,\ndescription is: Color White\ncomplexion Dank height 5 feet/d'inches,\nweight 169 pounds, color of hair\nGrey\ncolor of eyes They\nweight 160 pounds, color of hair Dark color of eyes Grey\nother visible distinctive marks\nnone\nother visible distinctive marks\nnone\n:\nI was born in Buntridge\nwas born in Charlotteta.\nEngland on the 2nd day of June\n, anno\nCauada\non the\n8th\nday of\nSept\nanno\nDomini I 856 1 now reside at 1012 Temple st Los Gingales bal\nDomini I 869 I now reside at 13thCist Santa monica bat\nI emigrated to the United States of America from antwerp Belzium\nI emigrated to the United States of America from Winnergag Canada\non the vessel Rordland\nmy last\non\nthe vessel Northern Pacific RR\nmy last\nforeign residence\nwas Beintridge England\nforeign\nresidence was J Himsing Canada\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nprince, potentate, state, or sovereignty, and particularly to Edward VII\nprince, potentate, state, or sovereignty, and particularly to Edward VII\nKing of Great Britian a Incland of which I am now a subject eitizen\nI\nKing of Gread Britian & Ireland of which I am now a subject citizen\nI\narrived at\nState the port of new york\nto\nthon\nin the\narrived at the port of\nXX Vincent\nto nuo oil in the\n5th\nState\nof\nnew york\non or about the\nday\nof\nDisteict\nBistriet\nnorth Dakoda 25 on or about the\n24th day\nof gune\nanno Domini I 896 I am not an anarchist; 1 am not a\nof\nDec\nanno Domini I 905-1 am not an anarchist; I 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 fáith\nto become a citizen of the United States of America and to permanently reside therein:\nto become a citizen of the United States of Ametica and to permanently reside therein:\nME\nWallace Leily Capples\nSo HELP\nME GOD. Solanan Mad characted HAL\n(Original signature of declarant.)\nas\n(Original signature or declarant.)\nSubscribed and sworn to before me this 17th\ndes\nztrit\nthis\nSubscribed and sworn to before me this 17th\n[SEAL.]\nday gune\n, anno Domini 19\nSEAL.] injoso onina\nday of give\nanno Domini igar\n0.G. Keyes\nC. G. Keges\nCOUNTY ARD\ns\nClerk of Court.\nBy Administer Deputy OF\nClerk of\nCourt.\nClerk.\nDesuty Clerk."
}