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532
TRIPLICATE
Form 2203,
No.
[To be given to the person making
the Declaration)
STATES OF
Department of Commerce and Tabor
BUREAU OF IMMIGRATION AND NATURALIZATION
DIVISION OF NATURALIZATION
DECLARATION OF INTENTION
(Invalid for all purposés seven years after the date hereof)
In the SUPERIOR
Court
ST.ATE OF CALIFORNIA
SS :
THE STATE or CALIPORNIA,
County of Los,
Ingales of on IN aged AND oath FOR 50
Lee ANGELES COUNTY,
years,
occupation 3. Rene (state B. Jain do
declare that my personal
affism
is: Color White complexion
height inches,
feet
description
weight 142 pounds, color of hair Full
, color of eyes
other visible distinctive marks
None born in Curry
Domini 55% now reside at Toy Cataloon One Cara
(my/o) on : I the was 23 day of Paracting May anno
I
emigrated to the United States
I Cat of America Puella from Visteria B6 be given.] ; my
on the vessel
(If
the
alien arrived Otherwis than by character of conveyance or of travel duon company should
94
last
Victoria
foreign residence was
forever all allegiance and fidelity to any foreigp
prince, It is my potentate, bona fide state, intention or sovereignty, to renounce and particularly to 2, of which I am now a citizen : I
subject
arrived
at the port of Guilar on or about the 20
in the
State
day
Territory of
of District Committee anno Domini grt 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
to become a citizen of the United States of America and to permanently reside therein:
:
So HELP ME GOD.
Reter Campbill
(Original signature of declarant. Mackug
sworn to before me this 334
Subscribed and
[SEAL.]
day of anno Domini 7
December
C.S. Keyas,
By Cight of LOS SUPERIOR CLERK (sifery AND IN OF AND EX-ORPICIO CALIFORNIA: FOR THE CLERK or 11-2526
Clerk.
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Document data
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- Core
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- Type
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DTO data
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Context sent to Scholar
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"ocrText": "532\nTRIPLICATE\nForm 2203,\nNo.\n[To be given to the person making\nthe Declaration)\nSTATES OF\nDepartment of Commerce and Tabor\nBUREAU OF IMMIGRATION AND NATURALIZATION\nDIVISION OF NATURALIZATION\nDECLARATION OF INTENTION\n(Invalid for all purposés seven years after the date hereof)\nIn the SUPERIOR\nCourt\nST.ATE OF CALIFORNIA\nSS :\nTHE STATE or CALIPORNIA,\nCounty of Los,\nIngales of on IN aged AND oath FOR 50\nLee ANGELES COUNTY,\nyears,\noccupation 3. Rene (state B. Jain do\ndeclare that my personal\naffism\nis: Color White complexion\nheight inches,\nfeet\ndescription\nweight 142 pounds, color of hair Full\n, color of eyes\nother visible distinctive marks\nNone born in Curry\nDomini 55% now reside at Toy Cataloon One Cara\n(my/o) on : I the was 23 day of Paracting May anno\nI\nemigrated to the United States\nI Cat of America Puella from Visteria B6 be given.] ; my\non the vessel\n(If\nthe\nalien arrived Otherwis than by character of conveyance or of travel duon company should\n94\nlast\nVictoria\nforeign residence was\nforever all allegiance and fidelity to any foreigp\nprince, It is my potentate, bona fide state, intention or sovereignty, to renounce and particularly to 2, of which I am now a citizen : I\nsubject\narrived\nat the port of Guilar on or about the 20\nin the\nState\nday\nTerritory of\nof District Committee anno Domini grt 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\nto become a citizen of the United States of America and to permanently reside therein:\n:\nSo HELP ME GOD.\nReter Campbill\n(Original signature of declarant. Mackug\nsworn to before me this 334\nSubscribed and\n[SEAL.]\nday of anno Domini 7\nDecember\nC.S. Keyas,\nBy Cight of LOS SUPERIOR CLERK (sifery AND IN OF AND EX-ORPICIO CALIFORNIA: FOR THE CLERK or 11-2526\nClerk."
}