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Form 2908
755745
No. 3860 Vol 9 page 60
TRIPLICATE
[To be given
the Declaration)
STATES OF
Department of Commerce and Tabor
BUREAU OF
DIVISION
P.
NOV 26 1917
BUREAU
IV
INTENTION
(Invalid for all purposes seven years after the date hereof)
State of Wiscon in
In the
Cirouit
Court
SS :
Milwaukee County
of Milwaukeo County
3. William Weinstein
aged
24,
years,
occupation Clerk
, do declare on oath that my personal
description is: Color
White
, complexion
Fair
height 5 feet 31 inches,
weight 120 pounds, color of hair
Blaok
Btown
, color of eyes
other visible distinctive marks
None
:
I was born in
Dubno
Russi a
on the
18th
day of
May
anno
Domini 886 : I now reside at
666-10th St. Wilwaukee Wisconsin
Libau Russia
I emigrated to the United States of America from
on the vessel
Gradno
; my last
[If the allen arrived otherwise than by vessel, the character of conveyance or name of transportation company should be given.]
foreign residence was
Wareaw
Russia
It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign
prince, potentate, state, or sovereignty, and particularly to
Nicholas II
Emperor of all the Bussias
of which I am now a subject; L
arrived at the port of
Ampta New York
in the
New York
State of
on or about the
11th
day
of
September
anno Domini I 906 : I am not an anarchist; 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 America and to permanently reside therein:
So HELP ME GOD.
William Winstein
(Origina) signatuire of declayent.)
19th
Subscribed and sworn to before me this
10
[SEAL
day of October anno Domini 19
Frod
Oirouiti
Clerk of the
Depaty
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"ocrText": "Form 2908\n755745\nNo. 3860 Vol 9 page 60\nTRIPLICATE\n[To be given\nthe Declaration)\nSTATES OF\nDepartment of Commerce and Tabor\nBUREAU OF\nDIVISION\nP.\nNOV 26 1917\nBUREAU\nIV\nINTENTION\n(Invalid for all purposes seven years after the date hereof)\nState of Wiscon in\nIn the\nCirouit\nCourt\nSS :\nMilwaukee County\nof Milwaukeo County\n3. William Weinstein\naged\n24,\nyears,\noccupation Clerk\n, do declare on oath that my personal\ndescription is: Color\nWhite\n, complexion\nFair\nheight 5 feet 31 inches,\nweight 120 pounds, color of hair\nBlaok\nBtown\n, color of eyes\nother visible distinctive marks\nNone\n:\nI was born in\nDubno\nRussi a\non the\n18th\nday of\nMay\nanno\nDomini 886 : I now reside at\n666-10th St. Wilwaukee Wisconsin\nLibau Russia\nI emigrated to the United States of America from\non the vessel\nGradno\n; my last\n[If the allen arrived otherwise than by vessel, the character of conveyance or name of transportation company should be given.]\nforeign residence was\nWareaw\nRussia\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nprince, potentate, state, or sovereignty, and particularly to\nNicholas II\nEmperor of all the Bussias\nof which I am now a subject; L\narrived at the port of\nAmpta New York\nin the\nNew York\nState of\non or about the\n11th\nday\nof\nSeptember\nanno Domini I 906 : I am not an anarchist; 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 America and to permanently reside therein:\nSo HELP ME GOD.\nWilliam Winstein\n(Origina) signatuire of declayent.)\n19th\nSubscribed and sworn to before me this\n10\n[SEAL\nday of October anno Domini 19\nFrod\nOirouiti\nClerk of the\nDepaty"
}