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No. 071.
Form 2903
TRIPLIDATE
making
STATES OF
Department of Commerce and Tabne
BUREAU OF IMMIGRATION AND NATURALIZATION
To the Honorable
DIVISION OF NATURALIZATION
The petition
First. My
Second. M
DECLARATION OF INTENTION
Third. Iw
(Invalid-for all purposes seven years after the date hereof)
Fourth. I
anno Domini 18
STATE OF CALIFORNIA
County of
In the SUPERIOR
Court
anno Domini 18
SS:
IN AND FOR Los ANGELES COUNTY,
OfTHE STATE OF CALIFORNIA
Fifth. dei
at
Los
3,
Charles Payson
aged
62 years,
Sinth.
in
say
occupation
Butcher
do affirm that my personal
declare on oath
I have true.
description is: Color while , complexion light , height feet 7
inches,
mar
weight 180 pounds, color of hair
brey
,
color of eyes Blue
Lana
other visible distinctive marks
none
Minne
Christa
: I born in Nusom
was
Loratta
Harmany
,
9th
Seventh. I a
on the
day of
may
anno
to organized govern
Domini I 846 I now reside at 117 Dilman Ax Reshapples bad
intention to becom
I to the
emigrated United States of America from Hamburg Garmany
particularly to
to reside permanent
on
the vessel [If north the alien arrived human hlogh otherwise Line
; my last
Eighth. I am
than vessa). the character of conveyance or name of transportation company should be given.]
Nusom Harmany
Minth. I have
foreign residence was
14 am
day
It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign
petition, since the
prince, potentate, state, or sovereignty, and particularly to William II
petition.
Tenth. I have
Empiron of Germany
citimen
, of which I am now a subject I
Arwyork
sald potition was don
arrived at the port of
,
in the
State
Territory of
drwwork
on or about the
14th day
Attached herete
District
and-bator, together
of
June
, anno Domini 872 1 am not an anarchist: I am not a
the United States of
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
:
Declaration of I
So HELP ME GOD.
climisles Payson
(Original signature of declarant.)
23%
STATF
Subscribed and affirmed sworn to before me this
Cannet
[SEAL.]
day of
Sept
anno Domini 19 908
,
The aforesaid per
contents thereof that
C. G. Keyes
,
and bellef,
COUNTY CLERK AND EX-OFFICIO CLERK OF
THE BUPERIOR COURT IN AND FOR THE COUNTY
Clerk of the ANOSLES, STAYE OF CALIFORNIA.
Court.
Geor
By
governary
,
Deputy Clerk.
m
11-8588
being severally,
mediately preceding #
petition la made
D. 1923
petitioner la
to be admitted
and aworn to
anno Dombit 19.
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"ocrText": "No. 071.\nForm 2903\nTRIPLIDATE\nmaking\nSTATES OF\nDepartment of Commerce and Tabne\nBUREAU OF IMMIGRATION AND NATURALIZATION\nTo the Honorable\nDIVISION OF NATURALIZATION\nThe petition\nFirst. My\nSecond. M\nDECLARATION OF INTENTION\nThird. Iw\n(Invalid-for all purposes seven years after the date hereof)\nFourth. I\nanno Domini 18\nSTATE OF CALIFORNIA\nCounty of\nIn the SUPERIOR\nCourt\nanno Domini 18\nSS:\nIN AND FOR Los ANGELES COUNTY,\nOfTHE STATE OF CALIFORNIA\nFifth. dei\nat\nLos\n3,\nCharles Payson\naged\n62 years,\nSinth.\nin\nsay\noccupation\nButcher\ndo affirm that my personal\ndeclare on oath\nI have true.\ndescription is: Color while , complexion light , height feet 7\ninches,\nmar\nweight 180 pounds, color of hair\nbrey\n,\ncolor of eyes Blue\nLana\nother visible distinctive marks\nnone\nMinne\nChrista\n: I born in Nusom\nwas\nLoratta\nHarmany\n,\n9th\nSeventh. I a\non the\nday of\nmay\nanno\nto organized govern\nDomini I 846 I now reside at 117 Dilman Ax Reshapples bad\nintention to becom\nI to the\nemigrated United States of America from Hamburg Garmany\nparticularly to\nto reside permanent\non\nthe vessel [If north the alien arrived human hlogh otherwise Line\n; my last\nEighth. I am\nthan vessa). the character of conveyance or name of transportation company should be given.]\nNusom Harmany\nMinth. I have\nforeign residence was\n14 am\nday\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\npetition, since the\nprince, potentate, state, or sovereignty, and particularly to William II\npetition.\nTenth. I have\nEmpiron of Germany\ncitimen\n, of which I am now a subject I\nArwyork\nsald potition was don\narrived at the port of\n,\nin the\nState\nTerritory of\ndrwwork\non or about the\n14th day\nAttached herete\nDistrict\nand-bator, together\nof\nJune\n, anno Domini 872 1 am not an anarchist: I am not a\nthe United States of\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:\nDeclaration of I\nSo HELP ME GOD.\nclimisles Payson\n(Original signature of declarant.)\n23%\nSTATF\nSubscribed and affirmed sworn to before me this\nCannet\n[SEAL.]\nday of\nSept\nanno Domini 19 908\n,\nThe aforesaid per\ncontents thereof that\nC. G. Keyes\n,\nand bellef,\nCOUNTY CLERK AND EX-OFFICIO CLERK OF\nTHE BUPERIOR COURT IN AND FOR THE COUNTY\nClerk of the ANOSLES, STAYE OF CALIFORNIA.\nCourt.\nGeor\nBy\ngovernary\n,\nDeputy Clerk.\nm\n11-8588\nbeing severally,\nmediately preceding #\npetition la made\nD. 1923\npetitioner la\nto be admitted\nand aworn to\nanno Dombit 19."
}