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376 377 Repartment of Comuterce and Repartment of Commence anh Waber NATURALIZATION SERVICE NATURALIZATION SERVICE No. 5364 anda ORICINAL 5365 No. R STATES OF STATES OF DECLARATION OF INTENTION DECLARATION OF INTENTION (layalid, for all purposes seven years after the date hereof) (Invalid for all purposes seven years after the date hereof) ST.4-7 In the SUPERIOR Court STMTC of ss: The State of California. In the SUPERIOR Caunty of Los Angeles Court Caunty of Los Angeles in and for Los Angeles County. ss: of The State of California. ge, Heinrich Roth aged 29 years, g, George Edmund Parker aged 33 of in and for Los County. Failor years, occupation do declare on oath that my personal occupation Druggist , do declare on oath that my personal description is: Color White complexion Fair height 5 feet 7% Vinches, description is: Color White complexion Dark height 5 feet 5 inches, weight 160 pounds, color of hair Brown color of eyes Brown weight 165 pounds, color of hair Black color of eyes Brown other visible distinctive marks none other visible distinctive marks Sean on uffer lip. I was born in Katy Hungay I was born in Fr. of Glanford Wentworth Co. ,ontleansha on. the 2nd day of July anno Domini I 883; I now reside on the 23 day of Sept at 2819 Falson at (Give number, asreet, Los city or town, and angelin State. leal anno Domini I 879 I now reside at 710 So Broadway (Give Los angel Col LIVERPOOL, INGLAND number, stryet, city or town, I emigrated to the United States of America from 1 emigrated to the United States of America from Winder Cenada on the vessel Hermany : my last (If the allen arrived otherwise than by veasel, the character name of transportation company should be given.) on the vessel Cenadian Parific Rrs : my last Raty Hungary (II the allen arrived by yousel, the character of conveyance of name of transportation company should be given.) foreign residence was foreign residence was Filbury out 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 prince, potentate, state, or sovereignty, and particularly to Francis Francie Joseph, of Anstria and Apostolie King of Hungss of whom I am now a subject Ces. v, King of Great Britain and of whom I am now a subject ; Larrived at the port of NEW YORK in the , on or about the 12th day 1 arrived at the port of DETROIT , in the State of NEW YORK State of much on or about the day of Sept anno Domini 1910 I am not an anarchist: I am not a of Sept anno Domini I 897 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 therein: to become a citizen of the United States of America and to permanently reside therein: So HELP ME GOD. Heintich Roth So HELP ME GOD. (Orlglas) algnature of declarant.) George Edmund (Original algnature of Parker Subscribed and sworn to before me this 27th Subscribed and sworn to before me this 27th [SEAL ] day of Jan , 19! 3 anno Domini [SEAL.] day of Jan anno Domini 191.5 COUNTY CLERK AND EX-OFFICIO CLERK OF H. J. Lelande the SUFERIOR co. 17 AND FOR THE COUNTY H. J. Leland's in AND EX-OPFICIO CLERK COUNTE OF 6F Los ANCYCRS.STATE UF Clerk of the Court. Clerk of the Court By & Smith Dy Clerk. By Clack.

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    "ocrText": "376\n377\nRepartment of Comuterce and\nRepartment of Commence anh Waber\nNATURALIZATION SERVICE\nNATURALIZATION SERVICE\nNo. 5364\nanda\nORICINAL\n5365\nNo.\nR\nSTATES OF\nSTATES OF\nDECLARATION OF INTENTION\nDECLARATION OF INTENTION\n(layalid, for all purposes seven years after the date hereof)\n(Invalid for all purposes seven years after the date hereof)\nST.4-7\nIn the SUPERIOR\nCourt\nSTMTC of\nss:\nThe State of California.\nIn the SUPERIOR\nCaunty of Los Angeles\nCourt\nCaunty of Los Angeles\nin and for Los Angeles County.\nss:\nof\nThe State of California.\nge, Heinrich Roth\naged 29\nyears,\ng,\nGeorge Edmund Parker aged 33\nof in and for Los County.\nFailor\nyears,\noccupation\ndo declare on oath that my personal\noccupation Druggist\n, do declare on oath that my personal\ndescription is: Color White complexion Fair height 5 feet 7% Vinches,\ndescription is: Color White complexion Dark height 5 feet 5 inches,\nweight 160 pounds, color of hair Brown color of eyes Brown\nweight 165 pounds, color of hair Black color of eyes Brown\nother visible distinctive marks\nnone\nother visible distinctive marks Sean on uffer lip.\nI was born in\nKaty Hungay\nI\nwas born in Fr. of Glanford Wentworth Co. ,ontleansha\non. the\n2nd\nday of\nJuly\nanno Domini I 883; I now reside\non the\n23\nday of\nSept\nat\n2819 Falson at (Give number, asreet, Los city or town, and angelin State. leal\nanno Domini I 879 I now reside\nat\n710 So Broadway (Give Los angel Col\nLIVERPOOL, INGLAND\nnumber, stryet, city or town,\nI emigrated to the United States of America from\n1 emigrated to the United States of America from\nWinder Cenada\non the vessel\nHermany\n: my last\n(If the allen arrived otherwise than by veasel, the character\nname of transportation company should be given.)\non the vessel\nCenadian Parific Rrs\n: my last\nRaty Hungary\n(II the allen arrived by yousel, the character of conveyance of name of transportation company should be given.)\nforeign residence was\nforeign residence was\nFilbury\nout\nCanada\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\nprince, potentate, state, or sovereignty, and particularly to\nFrancis Francie Joseph, of Anstria and Apostolie King of Hungss\nof whom I am now a subject\nCes. v, King of Great Britain and\nof whom I am now a subject ;\nLarrived at the port of\nNEW YORK\nin the\n, on or about\nthe 12th day\n1 arrived at the port of\nDETROIT\n,\nin the\nState of\nNEW YORK\nState of\nmuch\non or about the\nday\nof\nSept\nanno Domini 1910 I am not an anarchist: I am not a\nof\nSept anno Domini I 897 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 therein:\nto become a citizen of the United States of America and to permanently reside therein:\nSo HELP ME GOD.\nHeintich Roth\nSo HELP ME GOD.\n(Orlglas) algnature of declarant.)\nGeorge Edmund (Original algnature of Parker\nSubscribed and sworn to before me this\n27th\nSubscribed and sworn to before me this\n27th\n[SEAL ]\nday of\nJan , 19! 3\nanno Domini\n[SEAL.]\nday\nof Jan anno Domini\n191.5\nCOUNTY CLERK AND EX-OFFICIO CLERK OF\nH. J. Lelande the SUFERIOR co. 17 AND FOR THE COUNTY\nH. J. Leland's in AND EX-OPFICIO CLERK COUNTE\nOF\n6F Los ANCYCRS.STATE UF\nClerk of the\nCourt.\nClerk of the\nCourt\nBy\n& Smith Dy Clerk.\nBy\nClack."
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