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ORIGINAL
2A9 DIRO
TIDIRO
on
No. 8117
U.S.DEPARTMENTOFLABOR
No 8110
Bitz
OF
DECLARATION QE INTENTION
DECLARATION OFI INTENTION
Invalid for all purposes seven years after the date hereof
Invalid for all purposes seven years after the date hereof
STATE
al
In the
SUPERIOR Court
STATE OF DALIFORNIA
nl
County of Los
The State of California
In the
SURERIOR
Caunty of Los Angeles
Court
ss:
of
in and for Los Angeles County
ss:
The State of California.
to
of
in and. for Los Angeles Connty.
ge, Theodow Previch aged 22 Fyears,
g, nervars aged 40 yyers,
occupation
Labour
do declare on oath that my personal
occupation Labour
do declare on oath that my personal
description is: Color white complexion medium height 5 feet 6 inches,
description is: Color white complexion Dank , height
feet 6 inchés,
weight 154 pounds, color of hair L. Brown color of eyes Brown
weight 135 pounds, color of hair Black color of eyes
B nown
other visible distinctive marks
none
other visible distinctive marks
none
I
was born in Irebinge, Austria
I was
on
the 15th day of Zovember anno Domini I 8921 now reside
on
the 9th day of Warch anno Domini I 874 I now reside
born in guanaguata, mexico
at
644 N Broadway, (Give number, street, citalo Los State.) Angeles, Cal
at
and
I emigrated to the United States of
America from Trieste austria
I
emigrated to the United States of America from silab mexico
42 7 alexander (Give number, st street, or Los town, and State.) angeles, Cal
on the vessel
Panonia
my last
on the vessel..
(If the alien arrived otherwise than by veasel, the character of conveyance or name of transportation company should be given.)
(11 the allen arrived otherwise than by veasel, the character of cogveyance or name of transportation compange be given.)
mesican Central Ray
: my last
foreign residence was
Frebinje, austria
foreign residence was
Silas, mexics
It is my bona fide intention to renounce férever 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 The united
Francis foeeph, Empa. d. of Anstria and Apostelic King of of whom 1 am now a subject:
S later of mexico of whom I am now a-subject
d arrived at the port of
new york
to solt to in the
I arrived at the port of
Paso
in the
State
of
of march new york 910 on or about the day
14th
State of Texas
on or about the 9th day
anno Domini a I am not an anarchist: I am not a
of
January anno Domini 8857 am not an anarchist: 1 am not
a
polygamist nor a believer in the practice of polygamy: hand 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 land to permanently reside therein:
to become a citizen of the United States of America land to permanently reside therein:
So HELP ME GOD.
Thereon mist .oo Georish EM oe
So HELP ME GOD.
surgeon
francisco Butre havarro
(Original algnature of declarant,)
(Original algnature of doclarant.)
to
silt to sdi Subscribed and sworn to béfore mé in the office of the Clerk of
to
orlt
to
silt Subscribed land sworn to before me in the office of the Clerk of
[SEAL.
Court this tetan day of Dec anno Domini 191
[SEAL.]
wes Court this of Dec anno Domini 191
COUNTY CLERK ANO EX-OFFICIO CLERK OF
H. J.Lelande N SUPERTOR COURT IN FORTTHE COUNTY
"AND
H. J: Letande FOR THE COUNEY or
compry CLERK and EX-OFFICIO CLERK
COURT. IN AND
of LOS ANGELES. STATE OF CALIFORNIA.
or uns ANGELES. STATE OF CALIFORNAL
Clerk of the
Court.
of
Clerk of the
Court.
By
By Siggi Homeone Deputy Nom Clerk.
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- Core
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- Type
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"ocrText": "128\nORIGINAL\n2A9 DIRO\nTIDIRO\non\nNo. 8117\nU.S.DEPARTMENTOFLABOR\nNo 8110\nBitz\nOF\nDECLARATION QE INTENTION\nDECLARATION OFI INTENTION\nInvalid for all purposes seven years after the date hereof\nInvalid for all purposes seven years after the date hereof\nSTATE\nal\nIn the\nSUPERIOR Court\nSTATE OF DALIFORNIA\nnl\nCounty of Los\nThe State of California\nIn the\nSURERIOR\nCaunty of Los Angeles\nCourt\nss:\nof\nin and for Los Angeles County\nss:\nThe State of California.\nto\nof\nin and. for Los Angeles Connty.\nge, Theodow Previch aged 22 Fyears,\ng, nervars aged 40 yyers,\noccupation\nLabour\ndo declare on oath that my personal\noccupation Labour\ndo declare on oath that my personal\ndescription is: Color white complexion medium height 5 feet 6 inches,\ndescription is: Color white complexion Dank , height\nfeet 6 inchés,\nweight 154 pounds, color of hair L. Brown color of eyes Brown\nweight 135 pounds, color of hair Black color of eyes\nB nown\nother visible distinctive marks\nnone\nother visible distinctive marks\nnone\nI\nwas born in Irebinge, Austria\nI was\non\nthe 15th day of Zovember anno Domini I 8921 now reside\non\nthe 9th day of Warch anno Domini I 874 I now reside\nborn in guanaguata, mexico\nat\n644 N Broadway, (Give number, street, citalo Los State.) Angeles, Cal\nat\nand\nI emigrated to the United States of\nAmerica from Trieste austria\nI\nemigrated to the United States of America from silab mexico\n42 7 alexander (Give number, st street, or Los town, and State.) angeles, Cal\non the vessel\nPanonia\nmy last\non the vessel..\n(If the alien arrived otherwise than by veasel, the character of conveyance or name of transportation company should be given.)\n(11 the allen arrived otherwise than by veasel, the character of cogveyance or name of transportation compange be given.)\nmesican Central Ray\n: my last\nforeign residence was\nFrebinje, austria\nforeign residence was\nSilas, mexics\nIt is my bona fide intention to renounce férever 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 The united\nFrancis foeeph, Empa. d. of Anstria and Apostelic King of of whom 1 am now a subject:\nS later of mexico of whom I am now a-subject\nd arrived at the port of\nnew york\nto solt to in the\nI arrived at the port of\nPaso\nin the\nState\nof\nof march new york 910 on or about the day\n14th\nState of Texas\non or about the 9th day\nanno Domini a I am not an anarchist: I am not a\nof\nJanuary anno Domini 8857 am not an anarchist: 1 am not\na\npolygamist nor a believer in the practice of polygamy: hand 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 land to permanently reside therein:\nto become a citizen of the United States of America land to permanently reside therein:\nSo HELP ME GOD.\nThereon mist .oo Georish EM oe\nSo HELP ME GOD.\nsurgeon\nfrancisco Butre havarro\n(Original algnature of declarant,)\n(Original algnature of doclarant.)\nto\nsilt to sdi Subscribed and sworn to béfore mé in the office of the Clerk of\nto\norlt\nto\nsilt Subscribed land sworn to before me in the office of the Clerk of\n[SEAL.\nCourt this tetan day of Dec anno Domini 191\n[SEAL.]\nwes Court this of Dec anno Domini 191\nCOUNTY CLERK ANO EX-OFFICIO CLERK OF\nH. J.Lelande N SUPERTOR COURT IN FORTTHE COUNTY\n\"AND\nH. J: Letande FOR THE COUNEY or\ncompry CLERK and EX-OFFICIO CLERK\nCOURT. IN AND\nof LOS ANGELES. STATE OF CALIFORNIA.\nor uns ANGELES. STATE OF CALIFORNAL\nClerk of the\nCourt.\nof\nClerk of the\nCourt.\nBy\nBy Siggi Homeone Deputy Nom Clerk."
}