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Form 2903 No. 1405 TRIPLICATE to therperson making a the Declaration) STATES OF Department of Conumerce and Tabor BUREAU OF IMMIGRATION AND NATURALIZATION DIVISION OF NATURALIZATION DECLARATION OF INTENTION (Invalid for all purposes seven years after the date hereof) i County of Los Angeles ITE OF CALIFORNIAL In the SUPERIOR Court SS : ofthe STATE OF CALIFORNIA, IN AND FOR Los ANGELES COUNTY, 3, Charles Chicapular aged nt years, occupation merchank do affirm on that my personal declare oath description is: Color whis , Dark , height 5 feet 512 Linches, complexion weight 165 pounds, color of hair Black. , color of eyes Brown other visible distinctive marks none ; I was born in Tripolity Green on the 5's day of July , anno Domini I 884 ; I now reside at 700 Castalar St. Low bas I emigrated the United States of America from Near France to on the vessel French Line (If the allen arrived otherwise than by vessel, the character of conyeyance or name of transportation company should be given.] ; my last foreign residence was Inpolity Greece It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign prince, potentate, state, or sovereignty, and particularly to Gronge I Hing of Greece , of which I am now a citizen subject ; I arrived at the port of newyork in the State Territery of newyork on or about the 12 District day of October anno Domini 1901 I am not an anarchist: 1 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. Charlo Chairopular (Original signature of declarant.) Subscribed and sworn to before me this 16 affirmed [SEAL.] day of march anno Domini 1909 C. G. Keyes COUNTY GLEDK AND EX-ORFICIO CLERICOP Clark of ANGELES, BTAVE OF CALIFORNIA THE SUPERIOR COURT. IN AND FOR TAE COUNTY By garenday Depects Clark.

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    "ocrText": "Form 2903\nNo. 1405\nTRIPLICATE\nto therperson making\na the Declaration)\nSTATES OF\nDepartment of Conumerce and Tabor\nBUREAU OF IMMIGRATION AND NATURALIZATION\nDIVISION OF NATURALIZATION\nDECLARATION OF INTENTION\n(Invalid for all purposes seven years after the date hereof)\ni\nCounty of Los Angeles\nITE OF CALIFORNIAL\nIn the SUPERIOR Court\nSS :\nofthe STATE OF CALIFORNIA,\nIN AND FOR Los ANGELES COUNTY,\n3,\nCharles Chicapular\naged nt years,\noccupation\nmerchank\ndo affirm on that my personal\ndeclare oath\ndescription is: Color whis , Dark , height 5 feet 512 Linches,\ncomplexion\nweight 165 pounds, color of hair Black.\n, color of eyes\nBrown\nother visible distinctive marks\nnone\n; I was born in Tripolity\nGreen\non the\n5's\nday of\nJuly\n, anno\nDomini I 884 ; I now reside at 700 Castalar St. Low bas\nI emigrated the United States of America from Near France\nto\non the vessel\nFrench Line\n(If the allen arrived otherwise than by vessel, the character of conyeyance or name of transportation company should be given.]\n; my last\nforeign residence was\nInpolity Greece\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nprince, potentate, state, or sovereignty, and particularly to Gronge I\nHing of Greece\n,\nof which I am now a citizen\nsubject\n;\nI\narrived at the port of\nnewyork\nin the\nState\nTerritery of\nnewyork\non or about the\n12\nDistrict\nday\nof\nOctober\nanno Domini 1901 I am not an anarchist: 1 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 America and to permanently reside therein\nSo HELP ME GOD.\nCharlo Chairopular\n(Original signature of declarant.)\nSubscribed and sworn to before me this\n16\naffirmed\n[SEAL.]\nday of march\nanno Domini 1909\nC. G. Keyes\nCOUNTY GLEDK AND EX-ORFICIO CLERICOP\nClark of ANGELES, BTAVE OF CALIFORNIA\nTHE SUPERIOR COURT. IN AND FOR TAE COUNTY\nBy\ngarenday\nDepects\nClark."
}