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4523 NO2691 Form TRIPLICATE the Declaration) STATES OF Bepartment of Commerce and Tabur BUREAU OF IMMIGRATION AND NATURALIZATION RECEIVED DIVISION OF NATURALIZATION SEP 9790 BUREAU OF anno Domini ATORALIZATION Fifth. AMINED DECLARATION OF INTENTION Sixth. (Invalid for all purposes seven years after the date hereof) hase State of New York "Supreme In the Court SS : County of Westchenter of the State of New York 3. Cornilius Johanes Groen aged 23 years, occupation Florist -, do declare affirm. on oath that my personal Seventh. description is: Color white , complexion fair height 6 feet e inches, weight 173 pounds, color of hair light-brown , color of eyes blue intention other visible distinctive marks Scar on right cheek particularly reside : I was born in The Hague Fighth. Holland on the 23 April Ninth day of anno Domini I 886 : I now reside at Eagle Park Osaining N.Y. petition, this I emigrated to the United States of America from Rotterdam Holland petition. Tenth. on the vessel Ryn dam should be my last (M the allen arrived otherwise than by vessel, the character of conveyance or name of transportation company given.) foreign residence was Hampton England It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign Attached prince, potentate, state, or sovereignty, and particularly to Wilhelmina affidavit and queen of the Netherland 8 of which I am now a citizen I subject arrived at the port of New York in the Declaration State Tenritory of New York on or about the 24 day District of March anno Domini I 90 8 I am not an anarchist: I am not a , 87.17 polygamist nor a believer in the practice of polygamy: and it is my intention in good faith Caur to become a citizen of the United States of America and to permanently reside therein: the aforesaid So HELP ME GOD. Gronn. thereof' # (Original signature of declarant.) formation and be Subscribed and sworn to before me this n6th affinmed [SEAL.] day of May , anno Domini 19.09 Clay Geo W.Eelhodt Clerk of the Supreme Court. By Clerk.

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    "ocrText": "4523\nNO2691\nForm\nTRIPLICATE\nthe Declaration)\nSTATES OF\nBepartment of Commerce and Tabur\nBUREAU OF IMMIGRATION AND NATURALIZATION\nRECEIVED\nDIVISION OF NATURALIZATION\nSEP 9790\nBUREAU OF\nanno Domini\nATORALIZATION\nFifth.\nAMINED\nDECLARATION OF INTENTION\nSixth.\n(Invalid for all purposes seven years after the date hereof)\nhase\nState of New York\n\"Supreme\nIn the\nCourt\nSS :\nCounty of Westchenter\nof\nthe State of New York\n3.\nCornilius Johanes Groen\naged\n23\nyears,\noccupation Florist\n-, do declare affirm. on oath that my personal\nSeventh.\ndescription is: Color white , complexion fair\nheight 6 feet e inches,\nweight 173\npounds, color of hair light-brown , color of eyes\nblue\nintention\nother visible distinctive marks Scar on right cheek\nparticularly\nreside\n:\nI was born in\nThe Hague\nFighth.\nHolland\non the\n23\nApril\nNinth\nday of\nanno\nDomini I 886 : I now reside at Eagle Park Osaining N.Y.\npetition,\nthis\nI emigrated to the United States of America from Rotterdam Holland\npetition.\nTenth.\non the vessel Ryn dam should be my last\n(M the allen arrived otherwise than by vessel, the character of conveyance or name of transportation company given.)\nforeign residence was\nHampton England\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nAttached\nprince, potentate, state, or sovereignty, and particularly to\nWilhelmina\naffidavit and\nqueen of the Netherland 8\nof which I am now a\ncitizen I\nsubject\narrived at the port of\nNew York\nin the\nDeclaration\nState\nTenritory of\nNew York\non or about the\n24\nday\nDistrict\nof\nMarch\nanno Domini I\n90\n8\nI am not an anarchist: I am not a\n,\n87.17\npolygamist nor a believer in the practice of polygamy: and it is my intention in good faith\nCaur\nto become a citizen of the United States of America and to permanently reside therein:\nthe aforesaid\nSo HELP ME GOD.\nGronn.\nthereof'\n#\n(Original signature of declarant.)\nformation and be\nSubscribed and sworn to before me this n6th\naffinmed\n[SEAL.]\nday of May\n, anno Domini 19.09\nClay\nGeo W.Eelhodt\nClerk of the Supreme\nCourt.\nBy\nClerk."
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