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470
JAM 180,
LABOR
ORIGINAL
Indeved 471
8458
8459
LABOR
ORIGINAL
No.
No.
a
E
DECLARATION OFIINTENTION
DECLARATION OF INTENTION
Invalid for all purposes seven years after the date hereof
Invalid for all purposes seven
STATE OF
art n)
In the
SUPERIOR Court
STATE OF
art
nl
In
the
Caunty of Los ,Angeles
ss:
The State of California.
Caunty of Los Angeles
Court
ss:
The State of California.
of
in and for Los Angeles County,
of in and for Los Angeles
ge, Gerard Hendriklite Grown
aged 21 years,
,
g, nick Pusich Like
aged 33 years,
occupation Pattern maker
do declare on oath that my personal
occupation Laboren
do declare on oath that my personal
description is: Color White complexion med , height 6 feet
inches,
description issi Colot white complexion medium height feet
6
inches,
weight 162 pounds, color of hair Black à color of eyes Brown
weight 145 pounds, color of hair Black color of eyes B leve
other
visible distinctive marks scar on forched
glillery
radia
other visible distinctive marks
none
without
sidiaiv
I
was born in Pretaria Transvad south africa
I
was born in Konanle, austria
on the
19th day of
Felry
, anno Domini I 894 I now reside
on
the 6 the day of December anno Domini 1 881 I now reside
at
225 E. 10% st. Long Beach leae
at
(Give number, street, city or town and/plante)
or
I emigrated to the United States of America from Rotterdam Holland
640 z.grand (Give number, street, city town, ave and Staje.) Los angelee Cbe
I emigrated to the United States of America
from Have, France
on the vessel
Potsdam
my last
on the vessel
La Provence
? my last
(If the alien arrived by veasel, - charagter of conveyance gr name of transportation company ahould be given.)
(If the allen acrived othersise than the charnoter of conveyance or name of trateportation company chiould be given.)
foreign residence was
Holland
foreign residence was
K manle, austria
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 fallegiance and fidelity to any foreigh
prince, potentate, state, or sovereignty, and particularly to
prince, potentate, state, or sovereignty, and particularly to
George V, King of Great Britain and Ireland.
of whom 1 am now a subject:
Francls loseph 10
Eing. of Hungary, of whom I am now a subject
F arrived at the port of
NEW YORK
to tion is in the
I arrived at the port. of
new your to 1789
in the
State of
NEW YORK
on or about the 14th day
State of
of
nor
mas
of
november anno Domini t 90B am not an anarchist: I am not a
new you on or about the /
8th day
anno Domini 909: I am not an anarchist; 1 am not a
polygamist nor a believen in the practice of polygamy: and it is my intention in good faith
polygamist non a believen 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 thereins
So HELP ME GOD.
.000 HM 9.18H 08
So HELP ME GOD.
lo
Gerard Hendrik (Origina algnature of te declarany Green
Pusich
declarance
9N 433H 02
to
(Original alghature of declarent.)
to
adt
to
saltto arts Sübscribed and sworn, tó before mel in the office of the Clerk of
10 shelD arda to erlt Subscribed and sworn to before me in the office of the Clerk of
ISEAL.)
Court this 1st day of march anno Domini 191
IP* this it day of man anno Domini 194
AND EX-OFFICIO CLERK
COUNTY CLERK ANS EX-OFFICIO CLERK DE
10.
H. J. Lelande THE TH&
- H. J. Lelant'e AND FOR THE
STATE OF
OF LOS ANGELES, STATE OF CALIFORNIA
Clerk of the
Court.
two
Clork of the
Court
By
Clerk.
Atala
ARE
by Liggie Himors Deputy Clerk.
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"ocrText": "470\nJAM 180,\nLABOR\nORIGINAL\nIndeved 471\n8458\n8459\nLABOR\nORIGINAL\nNo.\nNo.\na\nE\nDECLARATION OFIINTENTION\nDECLARATION OF INTENTION\nInvalid for all purposes seven years after the date hereof\nInvalid for all purposes seven\nSTATE OF\nart n)\nIn the\nSUPERIOR Court\nSTATE OF\nart\nnl\nIn\nthe\nCaunty of Los ,Angeles\nss:\nThe State of California.\nCaunty of Los Angeles\nCourt\nss:\nThe State of California.\nof\nin and for Los Angeles County,\nof in and for Los Angeles\nge, Gerard Hendriklite Grown\naged 21 years,\n,\ng, nick Pusich Like\naged 33 years,\noccupation Pattern maker\ndo declare on oath that my personal\noccupation Laboren\ndo declare on oath that my personal\ndescription is: Color White complexion med , height 6 feet\ninches,\ndescription issi Colot white complexion medium height feet\n6\ninches,\nweight 162 pounds, color of hair Black à color of eyes Brown\nweight 145 pounds, color of hair Black color of eyes B leve\nother\nvisible distinctive marks scar on forched\nglillery\nradia\nother visible distinctive marks\nnone\nwithout\nsidiaiv\nI\nwas born in Pretaria Transvad south africa\nI\nwas born in Konanle, austria\non the\n19th day of\nFelry\n, anno Domini I 894 I now reside\non\nthe 6 the day of December anno Domini 1 881 I now reside\nat\n225 E. 10% st. Long Beach leae\nat\n(Give number, street, city or town and/plante)\nor\nI emigrated to the United States of America from Rotterdam Holland\n640 z.grand (Give number, street, city town, ave and Staje.) Los angelee Cbe\nI emigrated to the United States of America\nfrom Have, France\non the vessel\nPotsdam\nmy last\non the vessel\nLa Provence\n? my last\n(If the alien arrived by veasel, - charagter of conveyance gr name of transportation company ahould be given.)\n(If the allen acrived othersise than the charnoter of conveyance or name of trateportation company chiould be given.)\nforeign residence was\nHolland\nforeign residence was\nK manle, austria\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 fallegiance and fidelity to any foreigh\nprince, potentate, state, or sovereignty, and particularly to\nprince, potentate, state, or sovereignty, and particularly to\nGeorge V, King of Great Britain and Ireland.\nof whom 1 am now a subject:\nFrancls loseph 10\nEing. of Hungary, of whom I am now a subject\nF arrived at the port of\nNEW YORK\nto tion is in the\nI arrived at the port. of\nnew your to 1789\nin the\nState of\nNEW YORK\non or about the 14th day\nState of\nof\nnor\nmas\nof\nnovember anno Domini t 90B am not an anarchist: I am not a\nnew you on or about the /\n8th day\nanno Domini 909: I am not an anarchist; 1 am not a\npolygamist nor a believen in the practice of polygamy: and it is my intention in good faith\npolygamist non a believen 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 therein:\nto become a citizen of the United States of America and to permanently reside thereins\nSo HELP ME GOD.\n.000 HM 9.18H 08\nSo HELP ME GOD.\nlo\nGerard Hendrik (Origina algnature of te declarany Green\nPusich\ndeclarance\n9N 433H 02\nto\n(Original alghature of declarent.)\nto\nadt\nto\nsaltto arts Sübscribed and sworn, tó before mel in the office of the Clerk of\n10 shelD arda to erlt Subscribed and sworn to before me in the office of the Clerk of\nISEAL.)\nCourt this 1st day of march anno Domini 191\nIP* this it day of man anno Domini 194\nAND EX-OFFICIO CLERK\nCOUNTY CLERK ANS EX-OFFICIO CLERK DE\n10.\nH. J. Lelande THE TH&\n- H. J. Lelant'e AND FOR THE\nSTATE OF\nOF LOS ANGELES, STATE OF CALIFORNIA\nClerk of the\nCourt.\ntwo\nClork of the\nCourt\nBy\nClerk.\nAtala\nARE\nby Liggie Himors Deputy Clerk."
}