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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."
}