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OATH OF ALLEGIANCE
HTAO
,
that
I absolutels and abjure all and Adelity to any foreign prince, potentate
ticularly
Nicholas II.
RETITION FOR NATURALIZATION
en a subje
Jases
7 and the
198
to
To the Honorable
sill
Form 9908
TRIPLICATE
The
petition My place of is. Anyia 2440 Glen altyn number, Drive ally Dam Too Angeles Angeles County. Agreby Oal
the mus Superlor Court The State use
Cof for Los.
of and
NATURALIZATION SERVIOE
(Toje
show
No. 7945
-
before
STATES OF
Domini Fourth. , 895 emigrated and to arriped the United in Statel from on of about the
Third. Second. , My occupation born en the 21 Matterdi Domini 8P1 amelesdam Hallany
at
anno
the
Artterdam
Statemer
Hobaken
april
anno Demint 893 on the vesse?
on the
2 day of
Siath. to Account bécome e attisen tal in the States on Distract" tha 10 - Court or of name Mathem Ant of anno Califo 12
than by the Charactor . of convoyance cabsit
my
at
DECLARATION OF INTENTION
I am married
the
(levalid for all purposes seven yeare after the date hereof)
TIMCIA 30 93080
petition o,
, und theman hirts (Give number,
street, city
MORTHVRN DISTRICT OF CALIFORNIA
in Court, is
In the
DISTRICT
Court
bato at's new and MAN follows
ss:
ed States o)
CITY AND COUNTY OF SAN FRANCISCO.
of
THE UNITED STATES
2 - / diso -
on
30
nute
Anna Cathring Van Dam
aged
years,
g,
nd
occupation
Deaconess student
do declare on oath that my personal
1, p. 596),
loo to
description is: Color White
complexion Fad.r.
height 5 feet 6 inches,
to
Bevanth. 19 am not . or appoaed tolorganized governimente en . member of on aflicted with any organination or body of persona feaching diabelief in
weight 132
pounds, color of hair
Bromn
color of eyes
Grey
intention
organized government. 1 am nor believer in the practice of polygamy. , am attached to the principles of the Constitution of the United or op
other visible distinctive marks
Mone
particularly
to become to A of the United Wilhelmina, anounce Queen ofthe espolutely Nether and allegiance and Adelity to any foreign prince, potentate, state, States, or sovercignty and u
to reside permanently in the United States.
of whom at this time I am a subject, and is is my inter
I was born in
Amaterdam, Holland.
anno Domini I 881 I now reside
wighth. I am able to speak the English TRUOO 30 ASORO
petition of
on the
21st
day of
April
,
I have resided
self bas
the
129 Haight St. San Francisco, California
day of
may in the United anno States Domant of Amerleg 893 for and the in term the of Ave years at California least immediately `preceding the date of this petition, to wit,
at
(Give number, street, city or town, and State.)
this petidion, ainco the
-
I emigrated to the United States of America from Rotterdam, Holland.
day of Detaber anno Domini Josh State of being a residenes within this State of at continuously least one year next next preceding préceding the the de
of this ná
w
"Rotterdam'
: my last
on the vessel (If the allen arrived otherwise than by veasel, the character of conveyance or name of transportation cumpaby should be given.)
Tenth. I have not heratofore made patition for eitizenship to any court. (I AipiOn
of
at
Amsterdam, Holland.
on
foreign residence was
satchpartism Course for the fellowne reason and to wit,
an
REBY DEM
It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign
been
prince, potentate, state, or sovereignty, and particularly to
OUFEN OF THE NETHERLANDS
my of the two willnesses thereto, required by law. Wherefore your petitioner proys that he may be admitied a of the United States of Amerio
Attached and hareto the and made a part of this petition are my declaration of intention to become . altizon of the United States - together
of whom I am now a subject:
in the
Miss anna letter
I arrived at the port of
Hoboken,
aHOM
(Comples
of petilioner.)
on or about the
2nd
State of
Now, Jersey
day
of
anno Domini 1 893 : I am not an anarchist: 1 am not a
Declaration of Norem Intention - 98 the United Blates on om BEFORE 29, 1908, strike Chobor out the Ned words this reading Pand Certificate EM day of of Arrival August No. from Department of 1914 Labos."
May
,
polygamist nor a believer in the practice of polygamy: and it is my intention in good faith
AFFIDAVITS OF PETITIONER AND WITNESSES.
SEATE OF CALIFORNIA
to become a citizen of the United States of America and to permanently reside therein:
Onunty of Los Angeles
##:
So HELP ME GOD.
amailatha tan Dam
The patitioner being duly awora, deposes and sage that he laithe petétioner in the proceodiage: that he has read the foragoing petition and
Arnow
TVEUTED WITNESSES
(Original of doclarant.)
information and and that
contenta thereof that the said patition la algned with rull, true name/ that the de true of his own knowledge, excepté as do mattere therein stated to be'alleged
Subscribed and sworn to before me this
10th
Certufligance
au to those reattoré he 90 Sk
(Complete and true Agnature
[SEAL]
day of
Apri
anno Domini 191 2.
edmunity Jane
compation
and
JAS. P. BROWN.
ascupation
Heinektupes attorney tan Jasade
realding at 191 Achistiram
each
WAS.
UNITED STATES DISTRICT
being severally, duly, Miss tandam the abome mentioned to hare relded in the States
and la of the United State of that he has personolly known
immediately proceding the date of Allad Ale petition, the
M.F.Cett
Clerk of the
24 day of
dimu of
entitled potition le the
24
duly
Donglet be the State la which
By
pefitionar is - of mores attached day to the of of the or the United T and that 7e7 the and that de he has - personal way qualited, kroowledge
de be admitted - of the Uniled States
artic 0
a M
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"ocrText": "OATH OF ALLEGIANCE\nHTAO\n,\nthat\nI absolutels and abjure all and Adelity to any foreign prince, potentate\nticularly\nNicholas II.\nRETITION FOR NATURALIZATION\nen a subje\nJases\n7 and the\n198\nto\nTo the Honorable\nsill\nForm 9908\nTRIPLICATE\nThe\npetition My place of is. Anyia 2440 Glen altyn number, Drive ally Dam Too Angeles Angeles County. Agreby Oal\nthe mus Superlor Court The State use\nCof for Los.\nof and\nNATURALIZATION SERVIOE\n(Toje\nshow\nNo. 7945\n-\nbefore\nSTATES OF\nDomini Fourth. , 895 emigrated and to arriped the United in Statel from on of about the\nThird. Second. , My occupation born en the 21 Matterdi Domini 8P1 amelesdam Hallany\nat\nanno\nthe\nArtterdam\nStatemer\nHobaken\napril\nanno Demint 893 on the vesse?\non the\n2 day of\nSiath. to Account bécome e attisen tal in the States on Distract\" tha 10 - Court or of name Mathem Ant of anno Califo 12\nthan by the Charactor . of convoyance cabsit\nmy\nat\nDECLARATION OF INTENTION\nI am married\nthe\n(levalid for all purposes seven yeare after the date hereof)\nTIMCIA 30 93080\npetition o,\n, und theman hirts (Give number,\nstreet, city\nMORTHVRN DISTRICT OF CALIFORNIA\nin Court, is\nIn the\nDISTRICT\nCourt\nbato at's new and MAN follows\nss:\ned States o)\nCITY AND COUNTY OF SAN FRANCISCO.\nof\nTHE UNITED STATES\n2 - / diso -\non\n30\nnute\nAnna Cathring Van Dam\naged\nyears,\ng,\nnd\noccupation\nDeaconess student\ndo declare on oath that my personal\n1, p. 596),\nloo to\ndescription is: Color White\ncomplexion Fad.r.\nheight 5 feet 6 inches,\nto\nBevanth. 19 am not . or appoaed tolorganized governimente en . member of on aflicted with any organination or body of persona feaching diabelief in\nweight 132\npounds, color of hair\nBromn\ncolor of eyes\nGrey\nintention\norganized government. 1 am nor believer in the practice of polygamy. , am attached to the principles of the Constitution of the United or op\nother visible distinctive marks\nMone\nparticularly\nto become to A of the United Wilhelmina, anounce Queen ofthe espolutely Nether and allegiance and Adelity to any foreign prince, potentate, state, States, or sovercignty and u\nto reside permanently in the United States.\nof whom at this time I am a subject, and is is my inter\nI was born in\nAmaterdam, Holland.\nanno Domini I 881 I now reside\nwighth. I am able to speak the English TRUOO 30 ASORO\npetition of\non the\n21st\nday of\nApril\n,\nI have resided\nself bas\nthe\n129 Haight St. San Francisco, California\nday of\nmay in the United anno States Domant of Amerleg 893 for and the in term the of Ave years at California least immediately `preceding the date of this petition, to wit,\nat\n(Give number, street, city or town, and State.)\nthis petidion, ainco the\n-\nI emigrated to the United States of America from Rotterdam, Holland.\nday of Detaber anno Domini Josh State of being a residenes within this State of at continuously least one year next next preceding préceding the the de\nof this ná\nw\n\"Rotterdam'\n: my last\non the vessel (If the allen arrived otherwise than by veasel, the character of conveyance or name of transportation cumpaby should be given.)\nTenth. I have not heratofore made patition for eitizenship to any court. (I AipiOn\nof\nat\nAmsterdam, Holland.\non\nforeign residence was\nsatchpartism Course for the fellowne reason and to wit,\nan\nREBY DEM\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nbeen\nprince, potentate, state, or sovereignty, and particularly to\nOUFEN OF THE NETHERLANDS\nmy of the two willnesses thereto, required by law. Wherefore your petitioner proys that he may be admitied a of the United States of Amerio\nAttached and hareto the and made a part of this petition are my declaration of intention to become . altizon of the United States - together\nof whom I am now a subject:\nin the\nMiss anna letter\nI arrived at the port of\nHoboken,\naHOM\n(Comples\nof petilioner.)\non or about the\n2nd\nState of\nNow, Jersey\nday\nof\nanno Domini 1 893 : I am not an anarchist: 1 am not a\nDeclaration of Norem Intention - 98 the United Blates on om BEFORE 29, 1908, strike Chobor out the Ned words this reading Pand Certificate EM day of of Arrival August No. from Department of 1914 Labos.\"\nMay\n,\npolygamist nor a believer in the practice of polygamy: and it is my intention in good faith\nAFFIDAVITS OF PETITIONER AND WITNESSES.\nSEATE OF CALIFORNIA\nto become a citizen of the United States of America and to permanently reside therein:\nOnunty of Los Angeles\n##:\nSo HELP ME GOD.\namailatha tan Dam\nThe patitioner being duly awora, deposes and sage that he laithe petétioner in the proceodiage: that he has read the foragoing petition and\nArnow\nTVEUTED WITNESSES\n(Original of doclarant.)\ninformation and and that\ncontenta thereof that the said patition la algned with rull, true name/ that the de true of his own knowledge, excepté as do mattere therein stated to be'alleged\nSubscribed and sworn to before me this\n10th\nCertufligance\nau to those reattoré he 90 Sk\n(Complete and true Agnature\n[SEAL]\nday of\nApri\nanno Domini 191 2.\nedmunity Jane\ncompation\nand\nJAS. P. BROWN.\nascupation\nHeinektupes attorney tan Jasade\nrealding at 191 Achistiram\neach\nWAS.\nUNITED STATES DISTRICT\nbeing severally, duly, Miss tandam the abome mentioned to hare relded in the States\nand la of the United State of that he has personolly known\nimmediately proceding the date of Allad Ale petition, the\nM.F.Cett\nClerk of the\n24 day of\ndimu of\nentitled potition le the\n24\nduly\nDonglet be the State la which\nBy\npefitionar is - of mores attached day to the of of the or the United T and that 7e7 the and that de he has - personal way qualited, kroowledge\nde be admitted - of the Uniled States\nartic 0\na M"
}