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Form
and Eabor
TRIPLICATE
NATURALIZATION SERVICE
3561
No.
STATES OF
DECLARATION OF INTENTION
903
9031
(Invalid for all purposes seven years after the date hereof)
Fifth.
my
In the
SUPERIOR
Cour
CALIFORNIAL
in and for Los Angeles County.
Couredy of Los Angeles
ss:
The State of California.
of
thank
have
children
William Savideon
aged 34 year.
3,
bruqgist
do declare on oath that my personal
occupation description is: Color White complexion brown fair color of , height eyes flur feet
5
weight 121 pounds, color of hair
,
other visible distinctive
marks nows
Seventh.
Omenner, Outano, Canada
touganized
I was born in
intention
to
16th
day of May
anno Domini I 87b I now reside
ricularly to
on
the 92b It 42nd California
permanently in the U
at
emigrated to the United States of America (Give from Hinder, Canada
Bighth.
1
am
able
to
spel
Minth
I
have
I
the Canadian alien Pacific H.K. of
: my last
4
day of
vossel
transportation
company
should
begiven.)
on the residence (if was Toronto lawada
since the
8
CAL petition
foreign
It is my bona fide intention to renounce torever all allegiance and fidelity to any foreign
Tonth. I have not heretofo
prince, potentate, state, or sovereignty, and particularly to
retition was dented by the
Gee, V, King of Great Britain and Ireland,
, of whom I am now a subject; I
Detroit
in the
Attached hereto and made
arrived at the port of
Adavit and the affidavits
Michigan
on or about the
4 th
day
State of
November
anno Domini I 903; I am not an anarchist; I am not a
of
polygamist nor a believer in the practice of polygamy; and it is my intention in good faith
Declaration of Intention
to become a citizen of the United States of America and to permanently reside
therein:
So HELP ME GOD.
(original signature of declarant.)
Caunty if Los
Subscribed and sworn to before me
this 20th
aforesaid petitioner being
thereof: that the said peti
[SEAL]
July
anno Domini 191 1
day of
,
ation and belief, and that
H. J. LELANDE
BUPERIOR COUNTYY courr. IN AND FOR THE OCUNTY Court
OLERK AND EX OLERK or
Haurs
Clerk of ase cor
Nasyl
Carlu
Depects
Clent
estorally, duly, and
By
M
ately preceding the date of Alis
perition it mode
is . person of food
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Document data
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- Core
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- Type
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DTO data
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Context sent to Scholar
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Page context
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"ocrText": "Form\nand Eabor\nTRIPLICATE\nNATURALIZATION SERVICE\n3561\nNo.\nSTATES OF\nDECLARATION OF INTENTION\n903\n9031\n(Invalid for all purposes seven years after the date hereof)\nFifth.\nmy\nIn the\nSUPERIOR\nCour\nCALIFORNIAL\nin and for Los Angeles County.\nCouredy of Los Angeles\nss:\nThe State of California.\nof\nthank\nhave\nchildren\nWilliam Savideon\naged 34 year.\n3,\nbruqgist\ndo declare on oath that my personal\noccupation description is: Color White complexion brown fair color of , height eyes flur feet\n5\nweight 121 pounds, color of hair\n,\nother visible distinctive\nmarks nows\nSeventh.\nOmenner, Outano, Canada\ntouganized\nI was born in\nintention\nto\n16th\nday of May\nanno Domini I 87b I now reside\nricularly to\non\nthe 92b It 42nd California\npermanently in the U\nat\nemigrated to the United States of America (Give from Hinder, Canada\nBighth.\n1\nam\nable\nto\nspel\nMinth\nI\nhave\nI\nthe Canadian alien Pacific H.K. of\n: my last\n4\nday of\nvossel\ntransportation\ncompany\nshould\nbegiven.)\non the residence (if was Toronto lawada\nsince the\n8\nCAL petition\nforeign\nIt is my bona fide intention to renounce torever all allegiance and fidelity to any foreign\nTonth. I have not heretofo\nprince, potentate, state, or sovereignty, and particularly to\nretition was dented by the\nGee, V, King of Great Britain and Ireland,\n, of whom I am now a subject; I\nDetroit\nin the\nAttached hereto and made\narrived at the port of\nAdavit and the affidavits\nMichigan\non or about the\n4 th\nday\nState of\nNovember\nanno Domini I 903; I am not an anarchist; I am not a\nof\npolygamist nor a believer in the practice of polygamy; and it is my intention in good faith\nDeclaration of Intention\nto become a citizen of the United States of America and to permanently reside\ntherein:\nSo HELP ME GOD.\n(original signature of declarant.)\nCaunty if Los\nSubscribed and sworn to before me\nthis 20th\naforesaid petitioner being\nthereof: that the said peti\n[SEAL]\nJuly\nanno Domini 191 1\nday of\n,\nation and belief, and that\nH. J. LELANDE\nBUPERIOR COUNTYY courr. IN AND FOR THE OCUNTY Court\nOLERK AND EX OLERK or\nHaurs\nClerk of ase cor\nNasyl\nCarlu\nDepects\nClent\nestorally, duly, and\nBy\nM\nately preceding the date of Alis\nperition it mode\nis . person of food"
}