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Form 2908
No.3037
TRIPLICATE
Date the person making
the Declaration)
STATES
OF
First.
Third.
Department of Commerce and Tabor
Fourth
BUREAU OF IMMIGRATION AND NATURALIZATION
anno Domini
DIVISION OF NATURALIZATION
anno Domini
Fifth
at
V
DECLARATION OF INTENTION
Sixth
in
(Invalid for all purposes seven years after the date hereof)
Ihave
In the
SUPERIOR
Court
STATE OF CALIFORNIA
SS :
County of Los singeles
of THE STATE OF CALIFORNIA
IN AND FOR Los ANGE! OUTH
3.
andre Crevolin
aged 28 years,
occupation
Hotel Keeper do declare oath that my
on personal
description is: Color White complexion mediumanight Sinches,
weight 180 pounds, color of hair Brown , color of eyes Blue
intention
partícula
other visible distinctive marks
Scar in night Check
: I born in Chabottes
was
Ninth
France on the 24th day of november anno
Domini 1882 I now reside at 241 Aliso St Los Angeles Cas
thispetition,
petition
I emigrated to the United States
of America from Le Hance France
Tenth.
on the vessel
[In the alien arrived otherwise be given.)
La than by vessel, the Champagne character of converyance transportation company should
: my last
said
foreign residence was
Chabolter Fame
It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign
Attached
The
affidavit
prince, potentate, state, or sovereignty, and particularly to
Frends Republic
of which I am now a subject; I
arrived at the port of
new York
in the
Declaration
State of
new you
on or about the
4
day
of
november , anno Domini 903; I am not an anarchist; I am not
a
ST.4
polygamist nor a believer in the practice of polygamy: and it is my intention in good faith
Cat
to become a citizen of the United States of America and to permanently reside therein
The aforesa
So HELP ME GOD.
Andri Gevolin
contents thereof;
formation and
(Original signature of declarant.)
Subscribed and sworn to before me this
14th
a
[SEAL. ]
day of January Janno Domini 19 It
ma
being
H. J. LELANDE
GOUNTY
medialely prees
Clerk of
Court.
mitiled petition
By Jadams
Deputy
Clerk.
auid
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- Core
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- Type
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"ocrText": "Form 2908\nNo.3037\nTRIPLICATE\nDate the person making\nthe Declaration)\nSTATES\nOF\nFirst.\nThird.\nDepartment of Commerce and Tabor\nFourth\nBUREAU OF IMMIGRATION AND NATURALIZATION\nanno Domini\nDIVISION OF NATURALIZATION\nanno Domini\nFifth\nat\nV\nDECLARATION OF INTENTION\nSixth\nin\n(Invalid for all purposes seven years after the date hereof)\nIhave\nIn the\nSUPERIOR\nCourt\nSTATE OF CALIFORNIA\nSS :\nCounty of Los singeles\nof THE STATE OF CALIFORNIA\nIN AND FOR Los ANGE! OUTH\n3.\nandre Crevolin\naged 28 years,\noccupation\nHotel Keeper do declare oath that my\non personal\ndescription is: Color White complexion mediumanight Sinches,\nweight 180 pounds, color of hair Brown , color of eyes Blue\nintention\npartícula\nother visible distinctive marks\nScar in night Check\n: I born in Chabottes\nwas\nNinth\nFrance on the 24th day of november anno\nDomini 1882 I now reside at 241 Aliso St Los Angeles Cas\nthispetition,\npetition\nI emigrated to the United States\nof America from Le Hance France\nTenth.\non the vessel\n[In the alien arrived otherwise be given.)\nLa than by vessel, the Champagne character of converyance transportation company should\n: my last\nsaid\nforeign residence was\nChabolter Fame\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nAttached\nThe\naffidavit\nprince, potentate, state, or sovereignty, and particularly to\nFrends Republic\nof which I am now a subject; I\narrived at the port of\nnew York\nin the\nDeclaration\nState of\nnew you\non or about the\n4\nday\nof\nnovember , anno Domini 903; I am not an anarchist; I am not\na\nST.4\npolygamist nor a believer in the practice of polygamy: and it is my intention in good faith\nCat\nto become a citizen of the United States of America and to permanently reside therein\nThe aforesa\nSo HELP ME GOD.\nAndri Gevolin\ncontents thereof;\nformation and\n(Original signature of declarant.)\nSubscribed and sworn to before me this\n14th\na\n[SEAL. ]\nday of January Janno Domini 19 It\nma\nbeing\nH. J. LELANDE\nGOUNTY\nmedialely prees\nClerk of\nCourt.\nmitiled petition\nBy Jadams\nDeputy\nClerk.\nauid"
}