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210.3/78 ORIGINAL No. ORIGINAL STATES of STATES OF Department nf Commerce and Kabor Departmitent of Conmerce and Tabor 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) In the SUPERIOR Court SS: - AND FOR COUNTY, STATE OF FORNNIA In the SUPERIOR Court STATE OF CATIFORNIA SS : IN AND FOR Los ANGELES COUNTY, County of Lun Angeles of THE BITATE. de County ur Loradageles of THE STATE OF CALIFORNIA, * 3, John Bartender altman , aged 37 years, 3I. Anthony Kokat Dellarowe aged 21 no do that my personal declare on oath occupation Pharmacist Chemist do declare on oath years, occupation description is: Color, white complexion Dhark affirm height feet 6 inches, that my personal description is: Color White complexion Fair affirm height 5te feet 7 /4 inches, weight 136 pounds, color of hair Dark Brown cólor of eyes Brown weight 140 pounds, color of hair Brown color of eyes Blue other visible distinctive marks none other visible distinctive marks none I was born in Breslau : : I was born in Rathweiler Germany on the 26 day of may anno Germany , on the , 11th day of april anno Domini 873 I now reside at 406 Temple It to Angelen Cal I emigrated to the United States of Ameriça from montreal Canada I emigrated the United States of from Paris France Domini I 889: I now reside at 137 D Broadway Sos Ingles (LL to America the vesset (If Canadranthify the allen than by vessel, the chalacter spokane or name of transportation : my last on the vessel on foreign residence was montreal lanada company should be given.) foreign residence was Tares France (If the allen arrived ptherwise than by vegual, the of conveyance or name of transportation company should be given.) Cherbourg : my: last It intention to renounce forever all allegiance and fidelity to any foreign is my potentate, bona fide sovereignty, and particularly to George V It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign prince, state, or princé, potentate, state, or (sovereignty, and particularly to William II King of Great Britain and reland of which I am now a subject citimen I of which I am now a subject I arrived at the port of spokane in the arrived at the port of new your in the State Territory of Washington 1st day State on or about the Territory of new york on or about the 16 the day of District June anno Domini I 908; I am not an anarchist; I am not a of District October anno Domini I 910. 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 fäith 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 1 and to permanently reside therein: So HELP ME GOD. John (Original Altman signature of declarant.) HM o So HELP ME GOD. Anthonge wetrellarour of declarant.) Subscribed and affirmed sworn to before me this 21 Subscribed and affirmed before me sworn to this 21st [SEAL. ] day of march anno Domini 1911 [SEAL. Inimoti Grina day of march anno Domini 19 11 H. J. LELANDE H. J.LELANDE GOUNTY CLERK AND EX- OPFICIO CLEMK or BOUNTY CLERK ANO EX ORFICIO - THE SUPELIOR COURT IN AND FOR THE gounts THI SUPESTOR COURT IN AND FOR THE of court. By derk the OF LOA Deputy OR Clerk. By Clerk of the OF Clerk. COMP.

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    "ocrText": "210.3/78\nORIGINAL\nNo.\nORIGINAL\nSTATES of\nSTATES OF\nDepartment nf Commerce and Kabor\nDepartmitent of Conmerce and Tabor\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)\nIn the SUPERIOR Court\nSS:\n- AND FOR COUNTY,\nSTATE OF FORNNIA\nIn the SUPERIOR\nCourt\nSTATE OF CATIFORNIA\nSS :\nIN AND FOR Los ANGELES COUNTY,\nCounty of Lun Angeles\nof\nTHE BITATE. de\nCounty ur Loradageles\nof\nTHE STATE OF CALIFORNIA,\n*\n3, John Bartender altman\n, aged 37 years,\n3I. Anthony Kokat Dellarowe aged\n21\nno\ndo that my personal\ndeclare on oath\noccupation Pharmacist Chemist do declare on oath\nyears,\noccupation description is: Color, white complexion Dhark affirm height feet 6 inches,\nthat my personal\ndescription is: Color White complexion Fair affirm height 5te feet 7 /4 inches,\nweight 136 pounds, color of hair Dark Brown cólor of eyes Brown\nweight 140 pounds, color of hair Brown color of eyes Blue\nother visible distinctive marks none\nother visible distinctive marks none\nI was born in Breslau\n:\n:\nI was born in\nRathweiler\nGermany\non the\n26\nday of\nmay\nanno\nGermany\n,\non the\n,\n11th day of april\nanno\nDomini 873 I now reside at 406 Temple It to Angelen Cal\nI emigrated to the United States of Ameriça from montreal Canada\nI emigrated the United States of from Paris France\nDomini I 889: I now reside at 137 D Broadway Sos Ingles (LL\nto America\nthe vesset (If Canadranthify the allen than by vessel, the chalacter spokane or name of transportation\n: my last\non the vessel\non\nforeign residence was montreal lanada\ncompany\nshould be given.)\nforeign residence was Tares France\n(If the allen arrived ptherwise than by vegual, the of conveyance or name of transportation company should be given.)\nCherbourg\n: my: last\nIt intention to renounce forever all allegiance and fidelity to any foreign\nis my potentate, bona fide sovereignty, and particularly to George V\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nprince, state, or\nprincé, potentate, state, or (sovereignty, and particularly to William II\nKing of Great Britain and reland of which I am now a subject citimen\nI\nof which I am now a subject\nI\narrived at the port of spokane\nin the\narrived\nat the port of new your\nin the\nState Territory of Washington\n1st day\nState\non or about the\nTerritory of\nnew york\non or\nabout the 16 the day\nof\nDistrict June\nanno Domini I 908; I am not an anarchist; I am not\na\nof District October\nanno Domini I 910. I. am not an anarchist: I am not a\n,\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 fäith\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 1 and to permanently reside therein:\nSo HELP ME GOD.\nJohn (Original Altman signature of declarant.) HM\no\nSo HELP ME GOD.\nAnthonge wetrellarour of declarant.)\nSubscribed and affirmed sworn to before me this\n21\nSubscribed and affirmed before me\nsworn to this\n21st\n[SEAL. ]\nday of\nmarch anno Domini 1911\n[SEAL. Inimoti Grina\nday of march anno Domini 19 11\nH. J. LELANDE\nH. J.LELANDE\nGOUNTY CLERK AND EX- OPFICIO CLEMK or\nBOUNTY CLERK ANO EX ORFICIO -\nTHE SUPELIOR COURT IN AND FOR THE gounts\nTHI SUPESTOR COURT IN AND FOR THE\nof\ncourt.\nBy derk the OF LOA Deputy OR Clerk.\nBy Clerk of the OF Clerk. COMP."
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