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OCR
282225
Form ssos
TRIPLICATE
No. 2416
[Tob making
STATES A. OF
Department nf Commel
BUREAU OF IMMIGRATION
DIVISION OF
EXAMINED
DECLARATION OF INTENTION
(Invalid for all purposes seven years after the date hereof)
State-of-Ohio
In the
Common Pleas
Court
SS :
Quyahoga County
of
Cuyahoga County
3.
ter Bankowits
aged
28
years,
occupatión
piano finisher
do declare affirmen on oath that my personal
description is: Color white complexion fair height 5 feet 7 inches,
weight 155 pounds, color of hair brown
,
color of eyes
gray
other visible distinctive marks none.
:
I was born in Livland, Ruasia,
on the
lat
day of
August
anno
Ter
Domini 1879
; I now reside at 3782 Moodland Ave., Cleveland, Ohio.
I emigrated to the United States of America from
Hamburg, Germany,
on the vessel
Pretoria by vessel, the Character conveyance given.] my
last
(If the allen arrived otherwise than
of or name of transportation company should be
foreign residence was Livland, 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 Nichalas
II
Imperor of Russia
, of which I am now a
I
subject
,
in the
arrived at the port of New York,
State
New York,
on or about the
28th
day
Territory of
Districte-
of
July
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.
Piter Pankourts
(Original signature of declarant.)
Subscribed and sworn to before me this
9th
day of
July
anno
Domini 19 08.
Charlen P. Salen
de
Clork of the
Common Fleas
Court
By
Canb
Deputa Clerki
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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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Document source metadata
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Page context
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"ocrText": "282225\nForm ssos\nTRIPLICATE\nNo. 2416\n[Tob making\nSTATES A. OF\nDepartment nf Commel\nBUREAU OF IMMIGRATION\nDIVISION OF\nEXAMINED\nDECLARATION OF INTENTION\n(Invalid for all purposes seven years after the date hereof)\nState-of-Ohio\nIn the\nCommon Pleas\nCourt\nSS :\nQuyahoga County\nof\nCuyahoga County\n3.\nter Bankowits\naged\n28\nyears,\noccupatión\npiano finisher\ndo declare affirmen on oath that my personal\ndescription is: Color white complexion fair height 5 feet 7 inches,\nweight 155 pounds, color of hair brown\n,\ncolor of eyes\ngray\nother visible distinctive marks none.\n:\nI was born in Livland, Ruasia,\non the\nlat\nday of\nAugust\nanno\nTer\nDomini 1879\n; I now reside at 3782 Moodland Ave., Cleveland, Ohio.\nI emigrated to the United States of America from\nHamburg, Germany,\non the vessel\nPretoria by vessel, the Character conveyance given.] my\nlast\n(If the allen arrived otherwise than\nof or name of transportation company should be\nforeign residence was Livland, Russia.\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nprince, potentate, state, or sovereignty, and particularly to Nichalas\nII\nImperor of Russia\n, of which I am now a\nI\nsubject\n,\nin the\narrived at the port of New York,\nState\nNew York,\non or about the\n28th\nday\nTerritory of\nDistricte-\nof\nJuly\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.\nPiter Pankourts\n(Original signature of declarant.)\nSubscribed and sworn to before me this\n9th\nday of\nJuly\nanno\nDomini 19 08.\nCharlen P. Salen\nde\nClork of the\nCommon Fleas\nCourt\nBy\nCanb\nDeputa Clerki"
}