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284
3273
PRIGINAL
No. 3273
ORIGIÑAL
285
No.
STATES OF
STATES OF
Repartment of Cammerce and
Department 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
In the
SUPERIOR Court
S
STATE OF CALIFORNIA
ss :
Anb for Lee COUNTY,
ss:
IN AND FOR Loe ANDELIVO
of Los Aligeles
of
County of in
of
STATE DE CALIEDENLA
3, John William Brown do
aged 45 years,
3.
Sam Schiller
,
,
aged 29 years,
occupation gen Forman P.E.Ryco
declare on oath
affirm that my personal
do declare on oath
,
occupation Javiler
,
affirm
that my personal
description is:
Color White complexion Fair , height 5 feet 6 inches,
description is: Color White complexion Dark height 5 feet 9 inches,
weight 200 pounds, color of hair Brown , color of eyes Glay
weight 138 pounds; color of hair Black color of leyes
Black
none
other visible distinctive marks
other visible distinctive marks
none
I was
born in : Wagenham
:
I was born in Warsha
:
England , on
4th day of
October
Paland
the
, anno
,
on the
21st day of
Domini I 882 I now reside at 916 E gt at Las angeli bal.
may
, anno
Domini I 866 ; I now reside at 1606 Elittat Lar angeles bal
I emigrated to the
United States of America from Liverpoul England
Sardinian
I emigrated to the United States of America from Hamburg Hermany
on the vessel
on the vessel
: my last
(If
the
allen arrived otherwise than % the pharacter of conveyance of transportation pompany should be given.)
IN therallen arrived otherwise than by vessel, the character of conve Ince or name of transportation company shoold be given,
albany
: my last
1st Johals
foreign residence
foreign residence was
was Nowy-Alwor Paland
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 V
prince, potentate, state, or sovereignty, and particularly to Nicholas TI
Kingo of Great Britam and Irland of which 1 am now a citiasn subject
1
Emperor of all the Ruceive of which I
am
citizen.
now
a
subject
I
arrived at the port of
Detroil
in the
arrived at the port of
Am York
in the
State
28th day
State
Ferritary of
mich
on or about the
Tercitory of
District
New York on or about the 22nd day
Distriet
of
Fab.
anno Domini I 1901 I am not an anarchist: I am not
a
of
Feb
anno Domini 903: I am not an anarchist; 1 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 thépractice of polygamy: and it is my intention in good faith
to become a citizen of the United States of America and to permanently reside thereint
to become a citizen of the United States of America and to permanently reside therein:
So HELP ME GOD.
John (Original William signature of declarant.) Brown
So HELP ME GOD.
Sam Schiller
(Original signature of declarant.)
Subscribed and sworn to before me this
14th
Subscribed and sworn to before me this
14th
affirmed
affirmed
[SEAL
day of april
anno Domini 1911)
[SEAL:]
day of april
, anno Domini 19 11
H. J. LELANDE
H. J. LELANDE
OCUNTY OLank AND
BOUNTY AND -
THE BUPERVOR IN AND FOR THE DOUNTY
THE SUPTIUDE courry - AMD FOR THI GOUNTY
Clerk of the BTA 19 OF GAL WORNIA. Court.
Clerk of the OF LOS DE Court.
Elsmith
By
Ersmith Dy
Clerk
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"ocrText": "284\n3273\nPRIGINAL\nNo. 3273\nORIGIÑAL\n285\nNo.\nSTATES OF\nSTATES OF\nRepartment of Cammerce and\nDepartment 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\nSUPERIOR Court\nIn the\nSUPERIOR Court\nS\nSTATE OF CALIFORNIA\nss :\nAnb for Lee COUNTY,\nss:\nIN AND FOR Loe ANDELIVO\nof Los Aligeles\nof\nCounty of in\nof\nSTATE DE CALIEDENLA\n3, John William Brown do\naged 45 years,\n3.\nSam Schiller\n,\n,\naged 29 years,\noccupation gen Forman P.E.Ryco\ndeclare on oath\naffirm that my personal\ndo declare on oath\n,\noccupation Javiler\n,\naffirm\nthat my personal\ndescription is:\nColor White complexion Fair , height 5 feet 6 inches,\ndescription is: Color White complexion Dark height 5 feet 9 inches,\nweight 200 pounds, color of hair Brown , color of eyes Glay\nweight 138 pounds; color of hair Black color of leyes\nBlack\nnone\nother visible distinctive marks\nother visible distinctive marks\nnone\nI was\nborn in : Wagenham\n:\nI was born in Warsha\n:\nEngland , on\n4th day of\nOctober\nPaland\nthe\n, anno\n,\non the\n21st day of\nDomini I 882 I now reside at 916 E gt at Las angeli bal.\nmay\n, anno\nDomini I 866 ; I now reside at 1606 Elittat Lar angeles bal\nI emigrated to the\nUnited States of America from Liverpoul England\nSardinian\nI emigrated to the United States of America from Hamburg Hermany\non the vessel\non the vessel\n: my last\n(If\nthe\nallen arrived otherwise than % the pharacter of conveyance of transportation pompany should be given.)\nIN therallen arrived otherwise than by vessel, the character of conve Ince or name of transportation company shoold be given,\nalbany\n: my last\n1st Johals\nforeign residence\nforeign residence was\nwas Nowy-Alwor Paland\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nIt\nis my bona fide: intention to renounce forever all allegiance and fidelity to any foreign\nprince, potentate, state, or sovereignty, and particularly to George V\nprince, potentate, state, or sovereignty, and particularly to Nicholas TI\nKingo of Great Britam and Irland of which 1 am now a citiasn subject\n1\nEmperor of all the Ruceive of which I\nam\ncitizen.\nnow\na\nsubject\nI\narrived at the port of\nDetroil\nin the\narrived at the port of\nAm York\nin the\nState\n28th day\nState\nFerritary of\nmich\non or about the\nTercitory of\nDistrict\nNew York on or about the 22nd day\nDistriet\nof\nFab.\nanno Domini I 1901 I am not an anarchist: I am not\na\nof\nFeb\nanno Domini 903: I am not an anarchist; 1 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 thépractice of polygamy: and it is my intention in good faith\nto become a citizen of the United States of America and to permanently reside thereint\nto become a citizen of the United States of America and to permanently reside therein:\nSo HELP ME GOD.\nJohn (Original William signature of declarant.) Brown\nSo HELP ME GOD.\nSam Schiller\n(Original signature of declarant.)\nSubscribed and sworn to before me this\n14th\nSubscribed and sworn to before me this\n14th\naffirmed\naffirmed\n[SEAL\nday of april\nanno Domini 1911)\n[SEAL:]\nday of april\n, anno Domini 19 11\nH. J. LELANDE\nH. J. LELANDE\nOCUNTY OLank AND\nBOUNTY AND -\nTHE BUPERVOR IN AND FOR THE DOUNTY\nTHE SUPTIUDE courry - AMD FOR THI GOUNTY\nClerk of the BTA 19 OF GAL WORNIA. Court.\nClerk of the OF LOS DE Court.\nElsmith\nBy\nErsmith Dy\nClerk"
}