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No. 26425 Form 2:00 TRIPLICATE Declaration) STATES OF Department of Commerce and Tubur BUREAU OF IMMIGRATION AND NATURALIZATION DIVISION OF NATURALIZATION DECLARATION OF INTENTION (Invalid for all purposes seven years after the date hereof) State of New York, Circuit In the Court Southern Distrigt of New York, ss: the United States of aged 2v- years, occupation description is: Marcot Color while complexion dark do declare height on oath 521 that feet my personal inches, weight 130 pounds, color of hair black color of eyes brown other visible distinctive marks your I was borp in on the 2vt1- 9 Jassy day of anno Domini I now reside at Street Ofty of Dew York. 1 emigrated I to the of Ameriea from Genrun on the vessel last foreign residence It is my bona foreign (If fide was intention arrived to renounce by vesso the forever cortveyance all allegiance or and fidelity of Roumania, to any : my prince, potentate, state, or sovereignty, and particularly to Charles, King of which I am now a subject I New York arrived at the port of in the State Terri november New Youk 15- Dir of of anno Domini 907 on 1 am or about not an the anarchist: 1 am not day 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. Hairn signature Josip B 12- [SEAL ] Subscribed day of and Elerk sivorn your ofthe to before me this U. 8. Dirouis anno Domini 19 09 Court. By Deputy Clerk /

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Page
1237
Source index
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Type
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Page context
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    "ocrText": "No. 26425\nForm 2:00\nTRIPLICATE\nDeclaration)\nSTATES OF\nDepartment of Commerce and Tubur\nBUREAU OF IMMIGRATION AND NATURALIZATION\nDIVISION OF NATURALIZATION\nDECLARATION OF INTENTION\n(Invalid for all purposes seven years after the date hereof)\nState of New York,\nCircuit\nIn the\nCourt\nSouthern Distrigt of New York, ss:\nthe United States\nof\naged 2v- years,\noccupation description is: Marcot Color while complexion dark do declare height on oath 521 that feet my personal inches,\nweight 130 pounds, color of hair black\ncolor of eyes brown\nother visible distinctive marks\nyour\nI was borp\nin\non\nthe\n2vt1-\n9\nJassy\nday of\nanno\nDomini\nI now reside at\nStreet Ofty of Dew York.\n1\nemigrated I to the of Ameriea from Genrun\non the vessel\nlast\nforeign residence\nIt\nis my bona foreign\n(If fide was intention arrived to renounce by vesso the forever cortveyance all allegiance or and fidelity of Roumania, to any : my\nprince, potentate, state, or sovereignty, and particularly to Charles, King\nof which I am now a subject\nI\nNew York\narrived at the port of\nin the\nState\nTerri\nnovember\nNew Youk\n15-\nDir\nof\nof anno Domini 907 on 1 am or about not an the anarchist: 1 am not day\na\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.\nHairn signature Josip B\n12-\n[SEAL ]\nSubscribed day of and Elerk sivorn your ofthe to before me this U. 8. Dirouis\nanno Domini 19 09\nCourt.\nBy\nDeputy Clerk\n/"
}