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040 IRO ORIGINAL JAHIDIBO U.S. DEPARTMENTOFLABOR U.S. DEPARTMENT OF LABOR No. 8028 No. 8029 SERVIOE on STATES DECLARATION OF INTENTION DECLARATION OF INTENTION Invalid for all purposes seven years after the date hereof Invalia for all purpeses seven years after the date hereof STATE OF CALIFORMIA) of Los Ungeles ni In the SUPERIOR Court ard nl In the SUPERIOR ss: The State of California. Court of in and for Los Angeles Connty. Caunty Angeles ss: The State of California. of in and for Los Angeles County. de, nicholas Duryn aged 24 lyears, g, Christin Eleas Eickson aged 32:years years, occupation moving Picture Operator do declare on oath that my personal occupation varles description is; Color White complexion Light height 099 inches, description is: Color White complexion Face do declare on oath that my personal height 5 feet, 8 inches, weight 143 pounds, color of hair E.Brown none color of leyes 11 gray weight NV pounds, color of hair Fair color other visible distinctive marks other visible distinctive marks Name of cyest Brown I was born in Beemater, Holland I Ackdal was born in Venway on the 20th day of november anno Domini I 889 I now reside on the 9 day of aprel anno. Domini 882.11 now reside at 1319 w 8th (Give number, 98 street, city Los or town, and State.) Angeles, Cal at 3783 Harard (Give number, street, city or Angeles Oal I emigrated to the United States of America from vadelland antstrip, Belgium I emigrated to the United States of America from on the vessel : my last on the vessel stekla Christiana Verway (Il the alien arrived otherwise than by vessel, the character of sonveyance or of gompany ahould be given.) (11 the allen arrived than v veasel, the charseter of ognveyance or name of apportation company should be given.) ; my last foreign residence was Bruesele, Belgium foreign residence was Aleound arway 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 Wilhelmina, Queer : the Metherlands. of whom I am now a subject: Haakon VII, King of Nerwash 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 January anno Domini - 913 I am not an anarchist: I am new york on or about the 24th day NEW YORK State of on or about the 7 day not a of June anno Domini 903 I am not an anarchist; l'am not-a polygamist nor a believer in the practice of polygamy: and it is my intention in good faith polygamisti 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. 9JJH 08 nicholas Durn HELP ME yearly Ast Christin Eleas STOD BM Grickson 02 (Original signature of declarant.) So (Original algnasure of declarent.) Subscribed and swom to before me in the office of the Clerk of to arts lo soitto uni) Subscribed and to before in the of the Clerk of [SEAL.] Court this 12th day: of nov , anno Domini 191 101 [SEAL.] onns Court this sworn 5/2 day of Nave me office anno Domini 191 H. J. Lelande THE SUPERTOR CLERK COUNTY OF COUNTY CLERK AND EX-OFFICIO COURT IN AND FOR THE H. J. Lelande COUNTY CLERK AND EX-OFFICIO CLERK OF or STAYE of CALIFONRIA OF LOS-ANGELES, STATE OF CALIPORNIA, him ailt to Clerk of the Court. this Cleek of the Court. By Suppire Home Depents Clerk. $150 b) Clerk.

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    "ocrText": "040\nIRO\nORIGINAL\nJAHIDIBO\nU.S. DEPARTMENTOFLABOR\nU.S. DEPARTMENT OF LABOR\nNo. 8028\nNo. 8029\nSERVIOE\non\nSTATES\nDECLARATION OF INTENTION\nDECLARATION OF INTENTION\nInvalid for all purposes seven years after the date hereof\nInvalia for all purpeses seven years after the date hereof\nSTATE OF CALIFORMIA)\nof Los Ungeles\nni\nIn the\nSUPERIOR\nCourt\nard nl\nIn the SUPERIOR\nss:\nThe State of California.\nCourt\nof\nin and for Los Angeles Connty.\nCaunty Angeles\nss:\nThe State of California.\nof\nin and for Los Angeles County.\nde, nicholas Duryn\naged 24 lyears,\ng, Christin Eleas Eickson\naged 32:years years,\noccupation moving Picture Operator do declare on oath that my personal\noccupation varles\ndescription is; Color White complexion Light height 099 inches,\ndescription is: Color White complexion\nFace\ndo declare on oath that my personal\nheight 5 feet, 8 inches,\nweight 143 pounds, color of hair E.Brown none color of leyes 11 gray\nweight\nNV\npounds, color of hair Fair\ncolor\nother visible distinctive marks\nother visible distinctive marks\nName\nof cyest Brown\nI was born in\nBeemater, Holland\nI Ackdal\nwas born in\nVenway\non\nthe 20th day of november anno Domini I 889 I now reside\non the\n9\nday\nof aprel\nanno. Domini 882.11 now reside\nat\n1319 w 8th (Give number, 98 street, city Los or town, and State.) Angeles, Cal\nat\n3783 Harard (Give number, street, city or Angeles Oal\nI emigrated to the United States of America from\nvadelland antstrip, Belgium\nI emigrated to the United States of America from\non the vessel\n: my last\non the vessel\nstekla\nChristiana Verway\n(Il the alien arrived otherwise than by vessel, the character of sonveyance or of gompany ahould be given.)\n(11 the allen arrived than v veasel, the charseter of ognveyance or name of apportation company should be given.)\n; my last\nforeign residence was\nBruesele, Belgium\nforeign\nresidence\nwas\nAleound\narway\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\nWilhelmina, Queer : the Metherlands.\nof whom I am now a subject:\nHaakon VII, King of Nerwash\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 January anno Domini - 913 I am not an anarchist: I am\nnew york\non or about the 24th day\nNEW YORK\nState of\non or about the\n7\nday\nnot\na\nof\nJune anno Domini 903 I am not an anarchist; l'am not-a\npolygamist nor a believer in the practice of polygamy: and it is my intention in good faith\npolygamisti 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.\n9JJH 08\nnicholas Durn\nHELP ME yearly Ast Christin Eleas STOD BM Grickson 02\n(Original signature of declarant.)\nSo\n(Original algnasure of declarent.)\nSubscribed and swom to before me in the office of the Clerk of\nto\narts lo soitto uni) Subscribed and to before in the of the Clerk of\n[SEAL.]\nCourt this 12th day: of nov\n,\nanno Domini 191\n101\n[SEAL.] onns\nCourt this sworn 5/2 day of Nave me office\nanno Domini 191\nH. J. Lelande THE SUPERTOR CLERK COUNTY OF\nCOUNTY CLERK AND EX-OFFICIO\nCOURT IN AND FOR THE\nH. J. Lelande\nCOUNTY CLERK AND EX-OFFICIO CLERK OF\nor STAYE of CALIFONRIA\nOF LOS-ANGELES, STATE OF CALIPORNIA,\nhim\nailt\nto Clerk of the\nCourt.\nthis\nCleek of the\nCourt.\nBy Suppire Home Depents Clerk.\n$150\nb) Clerk."
}