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56 No. 30144 ORIGINAL No. 3045 ORIGINAL STATES OF STATES OF is Repartment of Contherce and Tabor Department of Conmerce and Kabor BUREAU OF IMMIGRATION AND NATURALIZATION BUREAU OF IMMIGRATION AND NATURALIZATION DIVISION OF NATURALIZATION DIVISION OF NATURALIZATION DECLARATION OF INTENTION DECLARATION OF INTENTION a (Invalid for all purposes/seven years after the date hereol) (Invalid for all purposes seven years after the date hereof) TATE OF CALIFORNIA SUPERIOR Court STATE OF In the County of Los Angeles County of Tos In the SUPERIOR Court ss: SS: of INAND FOR Los ANGELES COUNTY. of IN AND Lea malaness 26 THE STATE or GALIFORNIA, occupation 3. Jacobrieft Calpenter Bourgerie THE STATE OF CAL LIFORNIA, years, , aged 44 years, Labour do affirm that my personal declare on oath obcupation do declare on oath affirm that my personal description is: Color white complexion Fair height 5 feet 2 Linches, description is: Color White complexion Light 5 96 , height feet inches, weight 130 pounds, color of hair Darle Brown, color of eyes Gray weight 165 pounds, color of hair Light , color of eyes Blue other visible distinctive marks none other visible distinctive marks none : I was born in Seganne : I was born in new Brunswide Kent Co Gruw , on the 22 154 Richmondelk Pasadine Cas day of July anno Canada , on the 19 day of January , anno Domini 1885; I now reside at Domini 867 ; I now reside at 1054 moth St Las anythe Cas I emigrated to the United States of America from Patros Green I emigrated to the United States of America from new Brunswich Sl Aminiant : my last By Rais on the vessel en the vessel Boston of maine R R. (II the allen arrived otherwise thand by vessel, the character of conveyance or name of transportation company should be given.) [If the allen arrived otherwise than by vessel, the character of conveyance or name of transportation company should be given.] ; my last foreign residence was Beganne R Greece foreign residence was new Brunswick 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 George I prince, potentate, state, or sovereignty, and particularly to Georger being of the Greeks of which I am now a subject I citizen. arrived at the port of new your thing of Great Boston Britain W Ireland of which I am now a subject I in the arrivéd at the port of in the State State Territery of new yoh on or about the 25 day Territory of mass on, or about the 17 District District day of april , anno Domini I 900 I am not an anarchist: I am not a of December anno Domini I 8851 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 therein: to become a citizen of the United States of America and to permanently reside therein: So HELP ME GOD. So HELP ME GOD. gottend angelon Malamen (Origina) signature os/declarant.) fauth. (Original signature of declarant.) Boungens Subscribed and sworn affirmed to before me this 17 Subscribed and sworn to before me this affirmed 17 [SEAL.] day of January . , anno Domini 1911 [SEAL.] day of January , anno Domini 19 11 H. J. LELANDE H.J. LELANDE COUNTY OLERK AND EX-OPFICIO OLERK OF COUNTY CLERK AND EX OFFICIO OF Clerk of ANGEL EB. STASE OR THE SUPERIOR COURT. IN AND FOR THE COUNTY Court. Clerk of SUPERIOR COURT IN AND FOR THE COUNTY LOA. OR.CALIFORNIA Court. By farms Deficient Clerk. By garama Defunty Clerk.

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    "ocrText": "56\nNo. 30144\nORIGINAL\nNo. 3045\nORIGINAL\nSTATES OF\nSTATES OF\nis\nRepartment of Contherce and Tabor\nDepartment of Conmerce and Kabor\nBUREAU OF IMMIGRATION AND NATURALIZATION\nBUREAU OF IMMIGRATION AND NATURALIZATION\nDIVISION OF NATURALIZATION\nDIVISION OF NATURALIZATION\nDECLARATION OF INTENTION\nDECLARATION OF INTENTION\na\n(Invalid for all purposes/seven years after the date hereol)\n(Invalid for all purposes seven years after the date hereof)\nTATE OF CALIFORNIA\nSUPERIOR Court\nSTATE OF\nIn the\nCounty of Los Angeles\nCounty of Tos\nIn the\nSUPERIOR Court\nss:\nSS:\nof\nINAND FOR Los ANGELES COUNTY.\nof\nIN AND Lea\nmalaness 26\nTHE STATE or GALIFORNIA,\noccupation 3. Jacobrieft Calpenter Bourgerie\nTHE STATE OF CAL LIFORNIA,\nyears,\n,\naged 44\nyears,\nLabour\ndo affirm that my personal\ndeclare on oath\nobcupation\ndo declare on oath\naffirm\nthat my personal\ndescription is: Color white complexion Fair height 5 feet 2 Linches,\ndescription is: Color White complexion Light 5 96\n, height feet inches,\nweight 130 pounds, color of hair Darle Brown, color of eyes Gray\nweight 165 pounds, color of hair Light , color of eyes Blue\nother visible distinctive marks\nnone\nother visible distinctive marks\nnone\n:\nI\nwas born in Seganne\n: I was born in new Brunswide Kent Co\nGruw\n,\non the\n22\n154 Richmondelk Pasadine Cas\nday of July\nanno\nCanada\n,\non the\n19\nday of January\n, anno\nDomini 1885; I now reside at\nDomini 867 ; I now reside at 1054 moth St Las anythe Cas\nI emigrated to the United States of America from Patros Green\nI emigrated to the United States of America from new Brunswich\nSl Aminiant : my last\nBy Rais\non the vessel\nen the vessel\nBoston of maine R R.\n(II the allen arrived otherwise thand by vessel, the character of conveyance or name of transportation company should be given.)\n[If the allen arrived otherwise than by vessel, the character of conveyance or name of transportation company should be given.]\n; my last\nforeign residence was\nBeganne R Greece\nforeign residence was new Brunswick 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\nGeorge I\nprince, potentate, state, or sovereignty, and particularly to Georger\nbeing of the Greeks\nof which I am now a subject I\ncitizen.\narrived at the port of\nnew your\nthing of Great Boston Britain W Ireland of which I am now a subject\nI\nin the\narrivéd at the port of\nin the\nState\nState\nTerritery of\nnew yoh\non or about the\n25\nday\nTerritory of\nmass\non, or about the\n17\nDistrict\nDistrict\nday\nof april\n, anno Domini I 900 I am not an anarchist: I am not a\nof December anno Domini I 8851 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 therein:\nto become a citizen of the United States of America and to permanently reside therein:\nSo HELP ME GOD.\nSo HELP ME GOD.\ngottend angelon Malamen\n(Origina) signature os/declarant.)\nfauth. (Original signature of declarant.) Boungens\nSubscribed and sworn affirmed to before me\nthis\n17\nSubscribed and sworn to before me this\naffirmed\n17\n[SEAL.]\nday of January .\n, anno Domini 1911\n[SEAL.]\nday of January\n, anno Domini 19 11\nH. J. LELANDE\nH.J. LELANDE\nCOUNTY OLERK AND EX-OPFICIO OLERK OF\nCOUNTY CLERK AND EX OFFICIO OF\nClerk of ANGEL EB. STASE OR\nTHE SUPERIOR COURT. IN AND FOR THE COUNTY Court.\nClerk of\nSUPERIOR COURT IN AND FOR THE COUNTY\nLOA. OR.CALIFORNIA\nCourt.\nBy farms\nDeficient Clerk.\nBy garama\nDefunty\nClerk."
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