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214 No. 2703 ORIGINAL No. 2744 ORIGINAL STATES OF Department of Commerce aud Tabur Bepartmient of and Tabue 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 In the SUPERIOR Court STATE OF CALIFORNIA In the SUPERIOR Court County of SS: THE STATE OF County of Los Angeles SS: THE STATE OF CALIFORNIA of IN AND FOR Los ANGELES COUNTY, of IN AND FOR Los ANGELES COUNTY 3, Gustave Thomas Roberts aged 36 years, 3. Philiph Back aged 20 years, occupation Civil Engineer do declare affirm on oath that my personal occupation Butcher do affirm on oath that my personal declare description is: Color White complexion Fair height 5 feet 8 inches, description is: Color White complexion Fair height 5 feet 10 inches, weight 140 pounds, color of hair Brown color of eyes Gray none weight 164 pounds, color of hair Brown color of eyes Dray other visible distinctive marks other visible distinctive marks none ; I was born in Lyndhuret : I was born in Merxhain England , on the 6th day of December anno Manhattan Germany on the 23d day of may , anno Domini 883 I now reside at Balif Domini I 890 I now reside at Los Angeles bal I emigrated to the United States of America from I emigrated to the United States of America from on the vessel Adriatic : my last on the vessel Ghal Haldersea (If the allen arrived otherwise than by vessèl, the character of conveyance or name of tpansportation compapy should be given.] (If the allen arrived otherwise that by vessel, the character . conveyance or name of transpertation company should be given.] : my last foreign residence was London England foreign residence was Mercheim Germany 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 Georgitating prince, potentate, state, or sovereignty, and particularly to William II great Britaing & Areland of which I am now a eitisen subject I New york Enfuror of Germany of which I am now a eitizen subject I arrived at the port of in the arrived at the port of new york in the State Territory of New york on or about the 10th day District anno Domini 907 I am not an anarchist: I am not a State Dietrict December of new york anno Domini 903 on I am or about not an the anarchist; am not Territory 10th day of July of 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. Grastane Thomas goo Roberts oe So HELP ME GOD. (Original signature of declarant.) Philipp Bork COD 939H 02 12th (Origmal signature of declarant.) Subscribed and sworn affirmed to before me this Subscribed and sworn to before me this 14th [SEAL.] day of left , anno Domini 1910 [SEAL,] Inimoa onh day of Sept anno Domini 90 Keyes C. G. Keyes COUNTY CLERK AND EX OFFICIO CLEAK or THE SUPERIOR COURT IN AND FOR THE GOUNTY THE SUPERIOR EQUIT IN AID FOR COUNTY CLEIN AND EX ORFICIO QLERK OF OF OF GALIFORNIA, Counts the OF LOS CALIFORNIA, By mm-scott Deputy Clerk. By AM.Scott Deputy Clerk.

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    "ocrText": "214\nNo. 2703\nORIGINAL\nNo. 2744\nORIGINAL\nSTATES OF\nDepartment of Commerce aud Tabur\nBepartmient of and Tabue\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\nIn the\nSUPERIOR Court\nSTATE OF CALIFORNIA\nIn the\nSUPERIOR Court\nCounty of\nSS:\nTHE STATE OF\nCounty of Los Angeles\nSS:\nTHE STATE OF CALIFORNIA\nof\nIN AND FOR Los ANGELES COUNTY,\nof\nIN AND FOR Los ANGELES COUNTY\n3, Gustave Thomas Roberts aged 36 years,\n3. Philiph\nBack\naged 20 years,\noccupation\nCivil Engineer\ndo declare affirm on oath that my personal\noccupation\nButcher\ndo affirm on oath that my personal\ndeclare\ndescription is: Color White complexion Fair height 5 feet 8 inches,\ndescription is: Color White complexion Fair height 5 feet 10 inches,\nweight 140 pounds, color of hair Brown color of eyes Gray\nnone\nweight 164 pounds, color of hair Brown color of eyes Dray\nother visible distinctive marks\nother visible distinctive marks\nnone\n;\nI was born in\nLyndhuret\n: I was born in Merxhain\nEngland\n,\non\nthe\n6th\nday of December anno\nManhattan\nGermany on the 23d day of may\n, anno\nDomini 883 I now reside at\nBalif\nDomini I 890 I now reside at\nLos Angeles bal\nI\nemigrated to the United States of America from\nI\nemigrated to the United States of America from\non the vessel\nAdriatic\n: my last\non the vessel\nGhal Haldersea\n(If the allen arrived otherwise than by vessèl, the character of conveyance or name of tpansportation compapy should be given.]\n(If the allen arrived otherwise that by vessel, the character . conveyance or name of transpertation company should be given.]\n: my last\nforeign residence was\nLondon England\nforeign residence was\nMercheim Germany\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 Georgitating\nprince, potentate, state, or sovereignty, and particularly to William II\ngreat Britaing & Areland of which I am now a eitisen subject\nI\nNew york\nEnfuror of Germany of which I am now a eitizen\nsubject I\narrived at the port of\nin the\narrived at the port of\nnew york\nin the\nState\nTerritory of\nNew york\non or about the 10th day\nDistrict\nanno Domini 907 I am not an anarchist: I am not a\nState Dietrict December of new york anno Domini 903 on I am or about not an the anarchist; am not\nTerritory\n10th day\nof July\nof\na\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.\nGrastane Thomas goo Roberts\noe\nSo HELP ME GOD.\n(Original signature of declarant.)\nPhilipp Bork COD 939H\n02\n12th\n(Origmal signature of declarant.)\nSubscribed and sworn affirmed to before me this\nSubscribed and sworn to before me this 14th\n[SEAL.]\nday of left\n, anno Domini 1910\n[SEAL,]\nInimoa\nonh\nday of Sept\nanno Domini 90\nKeyes\nC. G. Keyes\nCOUNTY CLERK AND EX OFFICIO CLEAK or\nTHE SUPERIOR COURT IN AND FOR THE GOUNTY\nTHE SUPERIOR EQUIT IN AID FOR\nCOUNTY CLEIN AND EX ORFICIO QLERK OF\nOF OF GALIFORNIA,\nCounts\nthe OF LOS CALIFORNIA,\nBy mm-scott Deputy Clerk.\nBy AM.Scott Deputy Clerk."
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