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108 107 No. 1598 ORIGINAL No 4599 OBIGINAL STATES OF STATES OF Repartment of Commerce and Nabor Department of Conumerce and Tabur 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 CALLFORNIA In the SUPERIOR Court STATE OF CALIFORNIA County of Los Angeles ss: IN AND FOR Los ANGELES COUNT County of Los Angeles ss: In the SUPERISA Court S ofthe STATE QE CALIFORNIA. of THE RTATE or Loa 3. Jacob Goldbury aged zz. years, 3. Otto Ernest Schmuggles , aged 30. years, occupation Failon do declare affirm on oath that my personal occupation Waiter do declare on oath description is: Color whis affirm that my personal complexion Dark , height 5 feet inches, description is: Color while complexion Light , height 5 feet inches, weight 135. pounds, color of hair Brown color of leyes Brown weight 110 pounds, color of hair Light , color of eyes Grey other visible distinctive marks none other visible distinctive marks work none : I was born in Minete Russia , on the 20th of December day * anno Germany I was born in menselwitz on the 10th day of Domini I 887 : I now reside at 1041 so olive A Los Anyrh Oal may , anno Domini I 879 I now reside at Sania morning bal I emigrated to United States of America from Anturpp Brlgium the I Friedland emigrated to the United States of America from Hamburg Germany on the vessel 4 my last on the vessel (If the allén arrived otherwise than by vessel, the character of donvervance or name of transportation company should be given.) (If the allen arrived than by vessel, the aracter of conveyance or name of Kaiserin otherwise Augusts Victoria transportation Minak company should be given.) : my last foreign residence was Russia foreign residence was humany 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 Nicholas II prince, potentate, state, or sovereignty, and particularly to William II Emper of Russia citimen of which I am now a subject I Cemperon of bumany of which 1 am now a créizen subject I arrived at. the port of cturyors in the arrived at the port of State Aneyyork. 14th day State dewyork in the Temitory of on or about the Tessitory of District District stewyork on or about the 29th day of August anno Domini 1904 I am not an anarchist; I am not a of April anno Domini 906; I 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 faith to become a citizen of the United States of America and to permanently reside theiein: to become a citizen of the United States of America and to permanently reside therein: So HELP ME GOD. facel signature uno o2 Goldbag So HELP ME GOD. éclarant.) Other (Original Envent signature of dehmitylex declarant.) Subscribed and Affiemed sworn to before me this 21th day of F Subscribed and affirmed sworn to before me this 21 m [SEAL.] erviti anno Domini [SEAL.] day of June anno Domini 19 09 C. G. Keyes a THE SUPERIOR COURT IN AND FOR HIK COUNTY GOUNTY Glerk of the OS ANGELES, BTATE OF GALIFORNIA. Court. Glark of the OP LOS ANGELES STATE OF CALIFORNIA, THE BUPERIOR COURT IN FOR THE OQUNTY or By gro Contray Clerk. granday

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    "ocrText": "108\n107\nNo. 1598\nORIGINAL\nNo 4599\nOBIGINAL\nSTATES OF\nSTATES OF\nRepartment of Commerce and Nabor\nDepartment of Conumerce and Tabur\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 CALLFORNIA\nIn the\nSUPERIOR Court\nSTATE OF CALIFORNIA\nCounty of Los Angeles\nss:\nIN AND FOR Los ANGELES COUNT\nCounty of Los Angeles\nss:\nIn the SUPERISA\nCourt\nS\nofthe STATE QE CALIFORNIA.\nof THE RTATE or Loa\n3.\nJacob Goldbury\naged zz. years,\n3.\nOtto Ernest Schmuggles\n,\naged 30. years,\noccupation\nFailon\ndo declare affirm on oath that my personal\noccupation\nWaiter\ndo declare on oath\ndescription is: Color whis\naffirm\nthat my personal\ncomplexion Dark , height 5 feet inches,\ndescription is: Color while complexion Light , height 5 feet\ninches,\nweight 135. pounds, color of hair\nBrown\ncolor of leyes\nBrown\nweight 110 pounds, color of hair Light , color of eyes Grey\nother visible distinctive marks\nnone\nother visible distinctive marks\nwork\nnone\n: I was born in Minete\nRussia\n,\non the\n20th of December\nday\n* anno\nGermany\nI was born in menselwitz\non the\n10th\nday of\nDomini I 887 : I now reside at 1041 so olive A Los Anyrh Oal\nmay\n, anno\nDomini I 879 I now reside at\nSania morning bal\nI emigrated to United States of America from Anturpp Brlgium\nthe\nI\nFriedland\nemigrated to the United States of America from Hamburg Germany\non the vessel\n4 my last\non the vessel\n(If the allén arrived otherwise than by vessel, the character of donvervance or name of transportation company should be given.)\n(If the allen arrived than by vessel, the aracter of conveyance or name of\nKaiserin otherwise Augusts Victoria\ntransportation\nMinak\ncompany\nshould\nbe\ngiven.)\n: my last\nforeign residence was\nRussia\nforeign residence was\nhumany\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 Nicholas II\nprince, potentate, state, or sovereignty, and particularly to William II\nEmper of Russia\ncitimen\nof which I am now a subject\nI\nCemperon of bumany\nof which 1 am now a créizen\nsubject\nI\narrived at. the port of\ncturyors\nin the\narrived at the port of\nState\nAneyyork.\n14th day\nState\ndewyork\nin the\nTemitory of\non or about the\nTessitory of\nDistrict\nDistrict\nstewyork\non or about the 29th day\nof August\nanno Domini 1904 I am not an anarchist; I am not a\nof\nApril\nanno Domini 906; I 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 faith\nto become a citizen of the United States of America and to permanently reside theiein:\nto become a citizen of the United States of America and to permanently reside therein:\nSo HELP ME GOD.\nfacel signature uno\no2\nGoldbag\nSo HELP ME GOD.\néclarant.)\nOther (Original Envent signature of dehmitylex declarant.)\nSubscribed and Affiemed sworn to before me this\n21th\nday of F\nSubscribed and affirmed sworn to before me this 21 m\n[SEAL.]\nerviti\nanno Domini\n[SEAL.]\nday of June\nanno Domini 19 09\nC. G. Keyes\na\nTHE SUPERIOR COURT IN AND FOR HIK COUNTY\nGOUNTY\nGlerk of the OS ANGELES, BTATE OF GALIFORNIA.\nCourt.\nGlark of the OP LOS ANGELES STATE OF CALIFORNIA,\nTHE BUPERIOR COURT IN FOR THE OQUNTY or\nBy\ngro Contray\nClerk.\ngranday"
}