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98
0.8./DEPARTMENT OF LABOR
ORIGINAL
OF LABOR
ORIGINAL
No.
7080
No.
7581
0563 to
STATESIO
E
DECLARATION
DECLARATION OF:INTENTION
Z
Pinvalid for all purposes seven years after the date hereof
Mivalid for all purposes seven years aften the date/hereof
STATE OF
n)
In the
SUPERIOR Court
STATE OF
ortt at
In the SUPERIOR
Court
Oaunty of Los Angeles
The State of California.
Caunty of Los Andel es be MT
ss:
The State of California.
m and for Tos Anmeles Counts
insured
of
to
of la and for Los Angeles County.
Hereh Simhe filterstion
Penourn as Harry Silberstone
aged 28 years,
Jean Lamaison
aged 38 years,
occupation Failor
do declare on oath that my personal
occupation. stock -raiser do declare on oath that my personal
description is: Color White complexion med
height feet 11 inches,
description is:l Color white complexion Dark height feet 8 inches,
weight 215 pounds, color of hair Brown , color of eyes Blue
weight 155 pounds, color of hair Black color of eyes Brown
other visible distinctive marks Scaron forehesd
aldialy sadto
other visible distinctive marks
none
I was born in
Galaty Roumania
ai mod RISH 1
I was born in an Bager DD "oform France
on
the 10
day of
Dec
anno. Domini 1 885. I now reside
on the 15th day of march
anno Domini I 876; I now reside
at
510 W. Temple at for angeler leal
at
walnut Cal
(Give number, atreet, city or town,
(Give atreet, city or town, and State.)
I emigrated to the United States of America from
I remigrated to the United States of America
from Haver, France
on the vessel
Grand Trunk Ry
leaza my last
on the vessel
Polaria
: my last
(If the allen arrived ptherwise the et conveyance of transportation company
should
be
given.)
(It the allen arrived otherwise than by vensel, the character of conveyance or name of transpogtation company should be given.)
foreign residence was monthed termida
foreign
residence was am Bager D. oforon, France
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
Charles, King of Roumania.
of whom I am now a subject:
The Freach Republie
of whom I am now a subjecto
ceteren
I arrived at the port of
DETROIT
in the
I arrived at the port of
State of
mich
on or about the 29th day
new york
in the
State of
new york on or about the day
3rd
of
seft
anno Domini 1902 I am not an anarchist: I am not a
of Juby
anno Domini 1 8957 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 therd
So HELP ME GOD.
commonly as Harry Silverstone
HELP ME
Fibersh Smoke Lilberstein
(Original algnature of declarant.)
to layer
(Original adgnasure of declarant.) EM
Subscribed and sworn to before me this
commonly 6th
am
en Subscribed and sworn to before me this
6 the
[SEAL. nimoQ onns.
day of
ang
, anno Domini 191 4
[SEAL. onns to day
of ang
anno Domini 1914
GUNTY CLERK AND EX-OFFICIO CLERK of
J. Lelaado
COUNTY CLERK AMD EX-OFFICIO CLERK of
the
AJ. Lelande the you 21 AND FOR THE
GOUNCIR
AND soa THE COUNTY
OF LOS ANCELES, STATE OF ALIFORNIA.
OF LOS ANGELES STATE
a
-
SAS
Clerk of the
Court.
Clerk of the
Court.
By
Easmith
beh
Clerk.
14-46
a By Lizza Hissoun D specity Clerk.
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"ocrText": "92\n98\n0.8./DEPARTMENT OF LABOR\nORIGINAL\nOF LABOR\nORIGINAL\nNo.\n7080\nNo.\n7581\n0563 to\nSTATESIO\nE\nDECLARATION\nDECLARATION OF:INTENTION\nZ\nPinvalid for all purposes seven years after the date hereof\nMivalid for all purposes seven years aften the date/hereof\nSTATE OF\nn)\nIn the\nSUPERIOR Court\nSTATE OF\nortt at\nIn the SUPERIOR\nCourt\nOaunty of Los Angeles\nThe State of California.\nCaunty of Los Andel es be MT\nss:\nThe State of California.\nm and for Tos Anmeles Counts\ninsured\nof\nto\nof la and for Los Angeles County.\nHereh Simhe filterstion\nPenourn as Harry Silberstone\naged 28 years,\nJean Lamaison\naged 38 years,\noccupation Failor\ndo declare on oath that my personal\noccupation. stock -raiser do declare on oath that my personal\ndescription is: Color White complexion med\nheight feet 11 inches,\ndescription is:l Color white complexion Dark height feet 8 inches,\nweight 215 pounds, color of hair Brown , color of eyes Blue\nweight 155 pounds, color of hair Black color of eyes Brown\nother visible distinctive marks Scaron forehesd\naldialy sadto\nother visible distinctive marks\nnone\nI was born in\nGalaty Roumania\nai mod RISH 1\nI was born in an Bager DD \"oform France\non\nthe 10\nday of\nDec\nanno. Domini 1 885. I now reside\non the 15th day of march\nanno Domini I 876; I now reside\nat\n510 W. Temple at for angeler leal\nat\nwalnut Cal\n(Give number, atreet, city or town,\n(Give atreet, city or town, and State.)\nI emigrated to the United States of America from\nI remigrated to the United States of America\nfrom Haver, France\non the vessel\nGrand Trunk Ry\nleaza my last\non the vessel\nPolaria\n: my last\n(If the allen arrived ptherwise the et conveyance of transportation company\nshould\nbe\ngiven.)\n(It the allen arrived otherwise than by vensel, the character of conveyance or name of transpogtation company should be given.)\nforeign residence was monthed termida\nforeign\nresidence was am Bager D. oforon, France\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\nCharles, King of Roumania.\nof whom I am now a subject:\nThe Freach Republie\nof whom I am now a subjecto\nceteren\nI arrived at the port of\nDETROIT\nin the\nI arrived at the port of\nState of\nmich\non or about the 29th day\nnew york\nin the\nState of\nnew york on or about the day\n3rd\nof\nseft\nanno Domini 1902 I am not an anarchist: I am not a\nof Juby\nanno Domini 1 8957 am not an anarchist; I am not\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 therd\nSo HELP ME GOD.\ncommonly as Harry Silverstone\nHELP ME\nFibersh Smoke Lilberstein\n(Original algnature of declarant.)\nto layer\n(Original adgnasure of declarant.) EM\nSubscribed and sworn to before me this\ncommonly 6th\nam\nen Subscribed and sworn to before me this\n6 the\n[SEAL. nimoQ onns.\nday of\nang\n, anno Domini 191 4\n[SEAL. onns to day\nof ang\nanno Domini 1914\nGUNTY CLERK AND EX-OFFICIO CLERK of\nJ. Lelaado\nCOUNTY CLERK AMD EX-OFFICIO CLERK of\nthe\nAJ. Lelande the you 21 AND FOR THE\nGOUNCIR\nAND soa THE COUNTY\nOF LOS ANCELES, STATE OF ALIFORNIA.\nOF LOS ANGELES STATE\na\n-\nSAS\nClerk of the\nCourt.\nClerk of the\nCourt.\nBy\nEasmith\nbeh\nClerk.\n14-46\na By Lizza Hissoun D specity Clerk."
}