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No. 3057
Form 2903
TRIPLICATE
(Tote sives lo
STATES
(and
bu
Department of Connuerce and Tabur
BUREAU OF IMMIGRATION AND NATURALIZATION
DIVISION OF NATURALIZATION
ot
DECLARATION OF INTENTION
(Invalid for all purposes seven years after the date hereof)
DIATE OF CALIFORNIA
In the SUPERIOR Court
County of Los Angeles
SS :
of
IN AND FQB Loe ANOELES COUNTY,
3. Rallen Wilfred monkman the STATE aged - CAL 30
years,
occupation Druggist
do declare on oath that my personal
description is: Color White complexion
Fair , height 6 feet - inches,
weight 183 pounds, color of hair Black color of eyes Brown
other visible distinctive marks
none
Canada on : the was 9th march anno
I born in Seaforth Ontario
day of
,
Domini I 880; I now reside at 2845 n Griffen
I emigrated to the United States of America from Ontares Canada
on the vessel
(If By the arrived Tail on the Grand Trunk RR. my last
residence was Toronto Ontareo conveyance or name of trange Canada Altion company shogld be given.)
allen than by vessel, the of
foreign
prince, potentate, state, sovereignty, and particularly to George" V
It is my bona fide intention to renounce forever all allegiance; fidelity to any foreign
or
King of GreatBritain and hrolando which I am now a subject;
I
arrived at the port of Detroit
in the
State of michigan
on or about the 2nd
January
day
of
, anno Domini I 903 I am not an antarchist: 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 Ameriea and to permanently reside therein :
So HELP ME GOD.
Rollin (Original signature of declarant.)
Subscribed and sworn to before
24th
[SEAL. ]
day of January me anno this Domini 19 11
H. J. LELANDE
COUNTY CLABK - CLENK OF
By J.Chennell of OF Los avam Deputy or Clerk. Court.
the THE SUPERIOR - AND POR THE DOU
the
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Document data
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DTO data
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Context sent to Scholar
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"ocrText": "No. 3057\nForm 2903\nTRIPLICATE\n(Tote sives lo\nSTATES\n(and\nbu\nDepartment of Connuerce and Tabur\nBUREAU OF IMMIGRATION AND NATURALIZATION\nDIVISION OF NATURALIZATION\not\nDECLARATION OF INTENTION\n(Invalid for all purposes seven years after the date hereof)\nDIATE OF CALIFORNIA\nIn the SUPERIOR Court\nCounty of Los Angeles\nSS :\nof\nIN AND FQB Loe ANOELES COUNTY,\n3. Rallen Wilfred monkman the STATE aged - CAL 30\nyears,\noccupation Druggist\ndo declare on oath that my personal\ndescription is: Color White complexion\nFair , height 6 feet - inches,\nweight 183 pounds, color of hair Black color of eyes Brown\nother visible distinctive marks\nnone\nCanada on : the was 9th march anno\nI born in Seaforth Ontario\nday of\n,\nDomini I 880; I now reside at 2845 n Griffen\nI emigrated to the United States of America from Ontares Canada\non the vessel\n(If By the arrived Tail on the Grand Trunk RR. my last\nresidence was Toronto Ontareo conveyance or name of trange Canada Altion company shogld be given.)\nallen than by vessel, the of\nforeign\nprince, potentate, state, sovereignty, and particularly to George\" V\nIt is my bona fide intention to renounce forever all allegiance; fidelity to any foreign\nor\nKing of GreatBritain and hrolando which I am now a subject;\nI\narrived at the port of Detroit\nin the\nState of michigan\non or about the 2nd\nJanuary\nday\nof\n, anno Domini I 903 I am not an antarchist: 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 Ameriea and to permanently reside therein :\nSo HELP ME GOD.\nRollin (Original signature of declarant.)\nSubscribed and sworn to before\n24th\n[SEAL. ]\nday of January me anno this Domini 19 11\nH. J. LELANDE\nCOUNTY CLABK - CLENK OF\nBy J.Chennell of OF Los avam Deputy or Clerk. Court.\nthe THE SUPERIOR - AND POR THE DOU\nthe"
}