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130 MIDIRO ORIGINAL JAMIDI RO 131 U.S.DEPARTMENTE OF LABOR 008. DEPARTMENT ORISASOR ORIGINAL Nq 7618 AM No. 7619 .0M STATESIOR f DECLARATION PRIINTENTION DECLARATION OFINTENTION Invalid for all purposes seven years after the date hereof Tivalid for all purposes years after the dater hereof smare OF nl In the SUPERIOR Court stare or F6P artt al In the BURERIOR The State of Califormia Court Caunty of Los Angeles ss: of for Los Angeles County. Caunty of os Angeles ss: The State of California. lo of la and for Los Angeles Connty, ge, aged 27 years, anes g, august Hamsber raged 20 years, occupation Blacksitt do declare on oath that my personal occupation leabing maker do declare on oath that my personal description is: Color white complexion medium height 9 inches, description is: Color la white complexion Fair height feet 2 driches, weight 180 pounds, color of hair WD Brown color of eyes Brown weight 116 pounds, color of hair Bland ) colon of eyes other other visible distinctive marks none other visible distinctive marks now J was born in Prechina, austria I was born on the 14 the day of February anno Domini I 887 I now reside on the von 75th of in Oct Germany day anno Domini I 893 now reside at 2046 accromento (Give aumber, atreet, city st or town, d State.) Loc angeles, Cal at 11558 n. 41st st atreet, Los State.) angeles teal I the United States of America from Have, France (dive élty/or town, and emigrated to I emigrated to the United States of America from ANTWERP. BELGIUM on the vessel Sa Britagons : my last on the Ivessel King Frinkand last (11 the alien arrived otherwige than by vossel, the character of converance or name of transportation company ahould be given.) my (If the allen arrived otherwine veasel, the of conveyance gronme of transportation company given.) foreign residence, was Prechma, austria foreign residence was Hermany It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign my bona fide intention to renounce forever all allegiance and fidelity to any fofeign prince, potentate, state, or sovereignty, and particularly to prince, potentate, state, or sovereignty, and particularly to Brancis Joseph, Empers King of Hunght of whom I am now a subject; William II, German of whom I am now a subject; 4 arrived at the port of new york in the I arrived at the port of NEW YORK in the State of of December anno Domini 1 9071 am not an anarchist; 1 am not. a new york on or about the 24th day State of gil) lunds NEW YORK on or about the 3rd to day of april anno Domini G 912 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 thereing to become a citizen of the United States of America and to permanently reside therein: So HELP ME GOD. 02 So HELP ME GOD. GOD EAM 9.19H oe Joseph (Original algnature Parlel of declarant.) nah august (Original Haas alguatare of declerant.) 15th J31- eirtt Subscribed and sworn to hefore me this airit 98 Subscribed and sworn to before me this 15th [SEAL anne day of aug anno Domini 1914 [SEAL. timod onns day of aug , anno Domini 914 COUNTY CLERK AND EX-OFFICIO CLERK OF COUNTI CLERK AND EX-OFFICIO CLERK de H. J. Leland GRICA THE. or LOS ANGELES STATE OF CALIFORNIA. J. Lelande this UN 1A us OF CALIFORNIA. vill Clerk of the Court. sill to Clerk of the Court. By siggie Desperty Clerk. Jmla By the Essmith Dep Clerk.

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    "ocrText": "130\nMIDIRO\nORIGINAL\nJAMIDI RO\n131\nU.S.DEPARTMENTE OF LABOR\n008. DEPARTMENT ORISASOR\nORIGINAL\nNq 7618\nAM\nNo. 7619\n.0M\nSTATESIOR\nf\nDECLARATION PRIINTENTION\nDECLARATION OFINTENTION\nInvalid for all purposes seven years after the date hereof\nTivalid for all purposes years after the dater hereof\nsmare OF\nnl\nIn the\nSUPERIOR Court\nstare or\nF6P\nartt al\nIn the BURERIOR\nThe State of Califormia\nCourt\nCaunty of Los Angeles\nss:\nof for Los Angeles County.\nCaunty of os Angeles\nss:\nThe State of California.\nlo\nof\nla and for Los Angeles Connty,\nge,\naged 27 years,\nanes g, august Hamsber\nraged 20 years,\noccupation Blacksitt\ndo declare on oath that my personal\noccupation leabing maker\ndo declare on oath that my personal\ndescription is: Color white complexion medium height 9 inches,\ndescription is: Color la white complexion Fair\nheight feet 2 driches,\nweight 180 pounds, color of hair WD Brown color of eyes Brown\nweight 116 pounds, color of hair Bland ) colon of eyes other\nother visible distinctive marks\nnone\nother visible distinctive marks\nnow\nJ was born in Prechina, austria\nI was born\non\nthe 14 the day of February anno Domini I 887 I\nnow reside\non the von 75th of\nin Oct Germany\nday\nanno Domini I 893 now reside\nat 2046 accromento (Give aumber, atreet, city st or town, d State.) Loc angeles, Cal\nat\n11558 n. 41st st atreet, Los State.) angeles teal\nI the United States of America from Have, France\n(dive élty/or town, and\nemigrated to\nI emigrated to the United States of America from\nANTWERP. BELGIUM\non the vessel\nSa Britagons\n: my last\non the Ivessel\nKing\nFrinkand\nlast\n(11 the alien arrived otherwige than by vossel, the character of converance or name of transportation company ahould be given.)\nmy\n(If\nthe\nallen\narrived\notherwine veasel, the of conveyance gronme of transportation company given.)\nforeign residence,\nwas Prechma, austria\nforeign residence was\nHermany\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nmy bona fide intention to renounce forever all allegiance and fidelity to any fofeign\nprince, potentate, state, or sovereignty, and particularly to\nprince, potentate, state, or sovereignty, and particularly to\nBrancis Joseph, Empers\nKing of Hunght of whom I am now a subject;\nWilliam II, German\nof whom I am now a subject;\n4 arrived at the port of\nnew york\nin the\nI arrived at the port of\nNEW YORK\nin the\nState of\nof December anno Domini 1 9071 am not an anarchist; 1 am not. a\nnew york\non or about the 24th day\nState of\ngil)\nlunds\nNEW YORK\non or about the 3rd to day\nof\napril anno Domini G 912 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\nbecome a citizen of the United States of America and to permanently reside thereing\nto become a citizen of the United States of America and to permanently reside therein:\nSo HELP ME GOD.\n02\nSo HELP ME GOD.\nGOD\nEAM\n9.19H\noe\nJoseph (Original algnature Parlel of declarant.) nah\naugust (Original Haas alguatare of\ndeclerant.)\n15th\nJ31-\neirtt\nSubscribed and sworn to hefore me this\nairit 98 Subscribed and sworn to before me this\n15th\n[SEAL anne\nday of aug\nanno Domini 1914\n[SEAL. timod onns day of aug , anno Domini 914\nCOUNTY CLERK AND EX-OFFICIO CLERK OF\nCOUNTI CLERK AND EX-OFFICIO CLERK de\nH. J. Leland GRICA THE.\nor LOS ANGELES STATE OF CALIFORNIA.\nJ. Lelande this UN\n1A\nus OF CALIFORNIA.\nvill\nClerk of the\nCourt.\nsill to Clerk of the\nCourt.\nBy siggie Desperty Clerk.\nJmla\nBy\nthe Essmith Dep\nClerk."
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