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1010 Form TRIPLICATE the STATES OF Department of Commerce and Tabor BUREAU OF IMMIGRATION AND NATURALIZATION DIVISION OF NATURALIZATION DECLARATION OF 'INTENTION (Invilid for all purposes seven years after the date hereof) STATE SUPERIOR Court 3, County OF of Los Avgeles ss: In the of THE STATE or CALIFORNIA, - AND - Les GOUNTY, aged 32ve years, occupation Shepherder declare on oath description is Color thank complexion Dark do height 5 that feet 12/2 my personal inches, other visible distinctive marks weight 180 pounds, color of hair time Black color of eyes Brown Thang ; I was born in Aduda on the 16 day of 876 now at anno Domini I reside to States mg Harr and I emigrated the United of America from France Tenth. on the vessel residence (If the allen arrived Atduder ottrerwise thanks yoogel, conveyance or name of be given.] ; my last foreign was It my to renounce forever all allegiance and fidelity to prince, patentate, have state, is bona fide intention sovereignty, and any foreign State of at the port of for particularly to of which I am now a citizen subjeet I arrived of Distrist Newyork in the Jane on or about the of anno Domini 896 am not an anarchist; I am not a 2 day 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. John Ardans (Original signature Subscribed and swornt before me this 289 [SEAL.] day of affirgaed anno Domini 19 or a Court. By Clank

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175
Source index
0
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Document data

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Core
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Type
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Page context
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    "ocrText": "1010\nForm\nTRIPLICATE\nthe STATES OF\nDepartment of Commerce and Tabor\nBUREAU OF IMMIGRATION AND NATURALIZATION\nDIVISION OF NATURALIZATION\nDECLARATION OF 'INTENTION\n(Invilid for all purposes seven years after the date hereof)\nSTATE\nSUPERIOR\nCourt\n3, County OF of Los Avgeles ss: In the of THE STATE or\nCALIFORNIA, - AND - Les GOUNTY,\naged 32ve years,\noccupation Shepherder\ndeclare on oath\ndescription is Color thank complexion Dark do height 5 that feet 12/2 my personal inches,\nother visible distinctive marks\nweight 180 pounds, color of hair time Black color of eyes Brown\nThang\n; I was\nborn in Aduda\non the 16 day of\n876 now at\nanno\nDomini I reside\nto States\nmg Harr\nand\nI emigrated the United of America from France\nTenth.\non the vessel\nresidence (If the allen arrived Atduder ottrerwise thanks yoogel, conveyance or name of be given.] ;\nmy last\nforeign was\nIt my to renounce forever all allegiance and fidelity to\nprince, patentate, have state,\nis bona fide intention sovereignty, and any foreign\nState of at the port of for particularly to of which\nI am now a citizen\nsubjeet\nI\narrived\nof\nDistrist\nNewyork\nin the\nJane\non or about the\nof\nanno Domini\n896 am not an anarchist; I am not a\n2 day\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.\nJohn Ardans\n(Original signature\nSubscribed and swornt before me this 289\n[SEAL.]\nday of affirgaed anno Domini 19 or\na\nCourt.\nBy\nClank"
}