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No. 622
TRIPLICATE
Form 2803
(Tol be alven 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 purposes seven years after the date hereof)
ST.ATE OF CALIFORNIA
In the
SUPERIOR Court
County of Los Angeles
$S :
of
2. THE STATE -
3. Bogo Vastich
IN AND FOR Lee OBUNTY,
aged 21 years,
Laborer
, do declare affirm on oath that my personal
occupation
description is: Color white complexion Dark height Leet 9 inches,
weight 160 pounds, color of hair Brown color of eyes Brown
other visible distinctive marks
none
: I was born in Grave
Montogy
on the
25
day of
Dec
anno
Domini I 886 I now reside , at you adobe Lee Augula Rd
I emigrated to the United States of America from Hann Brance
Program
: my last
on the vessel
(If
the
allen arrived a by vessel, the character of conveyance or name of transportation company should be given.]
foreign residence was Grave
Monlayar
prince, Potentate, state, or sovereignty, and particularly to shohila
It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign
Chince of Montogoyou
of which I am now a subject ; I
citizen
New york
in the
arrived at the port of
State Territory District of New your
on or about the it day
of
April
anno Domini 1905 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.
Boso Nutified
(Original signature of declarant.)
Subscribed and affirmed sworn to before me this 12
day of Meby
anno Domini 19 of
[SEAL. ]
,
B.S.Clays,
OLERK AND EX-ONFIOIO CLARK OF
A
Clax of the of THE Lee OPUNTY OOURT. BTAKE IN OF AND CALIFORNIA. Fon Tris Court
By
significant Defen 11-2526 Clerk.
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Document data
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- Core
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- Type
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Context sent to Scholar
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"ocrText": "No. 622\nTRIPLICATE\nForm 2803\n(Tol be alven 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 purposes seven years after the date hereof)\nST.ATE OF CALIFORNIA\nIn the\nSUPERIOR Court\nCounty of Los Angeles\n$S :\nof\n2. THE STATE -\n3. Bogo Vastich\nIN AND FOR Lee OBUNTY,\naged 21 years,\nLaborer\n, do declare affirm on oath that my personal\noccupation\ndescription is: Color white complexion Dark height Leet 9 inches,\nweight 160 pounds, color of hair Brown color of eyes Brown\nother visible distinctive marks\nnone\n: I was born in Grave\nMontogy\non the\n25\nday of\nDec\nanno\nDomini I 886 I now reside , at you adobe Lee Augula Rd\nI emigrated to the United States of America from Hann Brance\nProgram\n: my last\non the vessel\n(If\nthe\nallen arrived a by vessel, the character of conveyance or name of transportation company should be given.]\nforeign residence was Grave\nMonlayar\nprince, Potentate, state, or sovereignty, and particularly to shohila\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nChince of Montogoyou\nof which I am now a subject ; I\ncitizen\nNew york\nin the\narrived at the port of\nState Territory District of New your\non or about the it day\nof\nApril\nanno Domini 1905 I am not an anarchist: I am not\na\n,\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\nSo HELP ME GOD.\nBoso Nutified\n(Original signature of declarant.)\nSubscribed and affirmed sworn to before me this 12\nday of Meby\nanno Domini 19 of\n[SEAL. ]\n,\nB.S.Clays,\nOLERK AND EX-ONFIOIO CLARK OF\nA\nClax of the of THE Lee OPUNTY OOURT. BTAKE IN OF AND CALIFORNIA. Fon Tris Court\nBy\nsignificant Defen 11-2526 Clerk."
}