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Forms 800 DERTIFICATE PURPOSER IN THE MATTER OF THE PETITION (For use of allens arriving In United Stutes after June 19, 1906. lesued nathough Pen Serial 75464-8-1079814 U. S. DEPARTMENT OF LABOR A CITIZEN or noi UNITED IMMIGRATION SERVICE OFFICE OF Commissioner STATES OF HTAQ AT Ellia Island, N. Y., Dec.10 1914 by declore, on oath, that A This is to certify that the following-named alien arrived at the port indicated, on the date and in the manner described below, vix: PETIFION FOR NATURALIZATION vereignty, and particularly Name of alien: Pugach, Leib hata have heretofore been a sub Port of entry New York, N. Y. Superlor bas To the Honorable the Date of arrival: July 9, 1906 The petition of First. place of Name of vessel: Umbria Cunard Truiri to Darlas 1504 tabe Drangelest Sengifyer sumber streed, diy lown, County. hereba Bled Oat showeth Cours of The State of lifornta. for Los Angeles reign and domestic; and f Second. My ocoupation la Angeli Third. I was born on the ibed and sworn to before m Title) Acting Commissioner Fourth. , emigrajed to the United 14 States day of from Appe anno Domin England GPP as on Schernyou or about the 2 day of Aussia 14-396 Or railroad company, or any other conveyance. anno Domini z. gok and arriped in the United States, atthe port of so Umbrica New your on the 9 July anno Domini 1 7on the vessel ihan by day of fully anunciation of adde of nobility, add the (Invalid for all purposes sevem years after the date hereof) 1 deffared become of SUPERIUR Court at anno STATE OF callFORMIA In the ss: The State of California. Court of The State of Catifornia in and far Les Caunty of Los Angeles of in and for Los Angeles County. in Benterenosta for 3 my Angeles married. to tusna a Cal of the now annu United resides the States as on Tos the Conganzer 4 andele Repedor day (Olve January Cal chould Augales Domini She was 912 born aged 26 years, Ihave children, and the name, date and place of birth, and place of residence of each of anid hildren number, le as follows: city or town, and nonsideration of the petition g, Leivu Pougatzoe Himony taken in open Court occupation Tailor do declare on oath that my personal citizen of the United State White complexion Dark , height -5--- feet 6 inches, Bernies Edward Born aug Angele description is: Color , . Jan 1910. further ordered, apon-const pounds, color of hair Blaok color of eyes Brown 155 , weight to,changed Carl other visible distinctive marks None Des 1912 Seventh. I am not a disbeliever in OF opposed to organized government or . member of or amliated with any organization or body of persons teaching disbelief in or opposed I was born in Tchernigey Russia to Court: organized government. I'am not a polyFamist not . in the practice of polygamy. I am attached to the principles of the Constitution of the United States, and u la my on the I4 day of Sept. anno Domini .885 I now reside , intencion to become a of the United States and to renounce absolutely and forever all allegiance and Adelity to any foreign prince, potentate, state, or sovereignty, and particularly to Nicholas II. Emperor of all the of whom at this time I am a subject,an " is my intention 932 Cottage Place Los Angeles Cal to reside permanently in the United States. at (Give number, street, city or town, and State.) I emigrated to the United States of America from LIVERPOOL, ENGLAND righth. , am able to speale the English language. Kinth consideration of the petition : my last Umbria otherwise than by veasel, the character of conveyance or nanse of transportation company should be given.) the on the vessel (If the this petition, since the 9 ddy of march anno and Domini in the State 907 of being a residence within this State of as continuously least one year next next preceding preceding the the date date 9 alien arrived I have resided July in the United States of America 906 for the term of Ave years at least immediately preceding the date of this patition, to wit, since day of anno Domini California foreign residence was Tchernigov Russia this petition. It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign Tenth. 1 have not heretofore made petition for eltizenship to any court. (I dade person for do the as prince, potentate, state, or sovereignty, and particularly to on the day of and-th said patition was assied bu the anid Court for reasons and Nicholas II, Emperor of all the Russias. , of whom I am now a subject; 1 and the of denial has sinca haen eured. or zamoned PETITION IS HEREBY I NNW YORK in the , I arrived at the port of Attoched hereto and made part of this petition are my declaration of intention to become oltizon of the United States and the certificate from the Department of Labor, together with NWW YORK on or about the 9th. day my and the of the two verifying witnesses thareto, required by law. Wherefore your petitioner prays that he may be admitted . citizon of the United States of America. State of of July anno Domini 906 : I am not an anarchist: I am not a true of polygamist nor a believer in the practice of polygamy; and it is my intention in good faith Des Congratzee pendioner.) Declaration of Intention and of Arrival No 1079814 from Department of Labor Ned this 18 Noma - or petitioner assived la the United States DM day of to become a citizen of the-United States of America and to permanently reside therein: Pertioner wishes name om Jowa 29, 1906, strike changed to pen out the words reading 'and Ceghificate No. Toget. from from AFFIDAVITS OF PETITIONER AND WITNESSES. So HELP ME GOD. to Seira (Original Bongatzee agnature of department) STATE OF Caunty of Los Angeles from to Subscribed and sworn to before me this 4th The aforesaid being duly deposes and aays that he is the petitioner in the above entitted proceedings; that he has read the foregoing pelition and knows the anno Domini 1912 contents thereof: that the auld pétition is signed with his full, true name: that the same u true of hie own knowledge, except - to maitera therein stated to be alleged day of January upon [SEAL] , information and bellef, and that to those maitera he believee COUNTY. CLERK. AND EX-OFFLCIO.I GLENK of H. J. Lelande THE SUPERIOR COURT IN AND FOR THE COUNTY OF LOS ANGELES. STATE OF CALIFORNIA. Lung Brame as occupation " to be true. mer Tailor Serve residion sebe (Complote and Pengagon Clerk of the Court. and Astoman Suplin litt. assupation Chemical as Palding at sech Clerk. asverally, duly, and repeetively deposse and sage of the United States that By immodiately the date of fling Ma aptition, use the day Crejike of above mestioned, anno he Dominid to has have parsonally known the United State States petition to mode alace the 7 in the in which the day of - Domina z and that he has personal that te of Naturalisation, No. the deld la . person of good charaster, attached to the principles of the Conatidution of the United Statex and that the pottaloner la in - qualifled opinion, to be admiticad . of the United havin Beams os NOLLOVDIO AND Solomon Supplie - and de the of the of Court this Is 29 14

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    "ocrText": "Forms 800\nDERTIFICATE\nPURPOSER\nIN THE MATTER OF THE PETITION\n(For use of allens arriving In United Stutes after June 19, 1906. lesued\nnathough Pen\nSerial\n75464-8-1079814\nU. S. DEPARTMENT OF LABOR\nA CITIZEN or noi UNITED\nIMMIGRATION SERVICE\nOFFICE OF Commissioner\nSTATES OF HTAQ\nAT\nEllia Island, N. Y., Dec.10 1914\nby declore, on oath, that A\nThis is to certify that the following-named alien arrived at the port indicated, on the date and in the\nmanner described below, vix:\nPETIFION FOR NATURALIZATION\nvereignty, and particularly\nName of alien: Pugach, Leib\nhata\nhave heretofore been a sub\nPort of entry New York, N. Y.\nSuperlor\nbas\nTo the Honorable the\nDate of arrival: July 9, 1906\nThe petition of\nFirst. place of\nName of vessel: Umbria\nCunard\nTruiri to Darlas 1504 tabe Drangelest Sengifyer sumber streed, diy lown, County. hereba Bled Oat showeth\nCours of The State of lifornta. for Los Angeles\nreign and domestic; and f\nSecond. My ocoupation la\nAngeli\nThird. I was born on the\nibed and sworn to before m\nTitle) Acting Commissioner\nFourth. , emigrajed\nto the United 14 States day of from Appe anno Domin England GPP as on Schernyou or about the 2 day of Aussia\n14-396\nOr railroad company, or any other conveyance.\nanno Domini z. gok and arriped in the United States, atthe port of\nso\nUmbrica\nNew your\non the\n9 July\nanno Domini 1 7on the vessel\nihan by\nday of fully\nanunciation of adde of nobility, add the\n(Invalid for all purposes sevem years after the date hereof)\n1 deffared become\nof\nSUPERIUR\nCourt\nat\nanno\nSTATE OF callFORMIA\nIn the\nss:\nThe State of California.\nCourt of The State of Catifornia in and far Les\nCaunty of Los Angeles\nof\nin and for Los Angeles County.\nin\nBenterenosta for 3 my Angeles married. to tusna a Cal of the now annu United resides the States as on Tos the Conganzer 4 andele Repedor day (Olve January Cal chould Augales Domini She was 912 born\naged 26\nyears,\nIhave\nchildren, and the name, date and place of birth, and place of residence of each of anid hildren number, le as follows: city or town,\nand\nnonsideration of the petition\ng,\nLeivu Pougatzoe\nHimony taken in open Court\noccupation\nTailor\ndo declare on oath that my personal\ncitizen of the United State\nWhite\ncomplexion\nDark\n, height -5--- feet 6 inches,\nBernies Edward Born aug Angele\ndescription is: Color\n,\n.\nJan 1910.\nfurther ordered, apon-const\npounds, color of hair Blaok\ncolor of eyes Brown\n155\n,\nweight\nto,changed\nCarl\nother visible distinctive marks\nNone\nDes 1912\nSeventh. I am not a disbeliever in OF opposed to organized government or . member of or amliated with any organization or body of persons teaching disbelief in or opposed\nI was born in\nTchernigey\nRussia\nto\nCourt:\norganized government. I'am not a polyFamist not . in the practice of polygamy. I am attached to the principles of the Constitution of the United States, and u la my\non the\nI4\nday of Sept.\nanno Domini .885 I now reside\n,\nintencion to become a of the United States and to renounce absolutely and forever all allegiance and Adelity to any foreign prince, potentate, state, or sovereignty, and\nparticularly to\nNicholas II. Emperor of all the\nof whom at this time I am a subject,an \" is my intention\n932 Cottage Place Los Angeles Cal\nto reside permanently in the United States.\nat\n(Give\nnumber, street, city or town, and State.)\nI emigrated to the United States of America from LIVERPOOL, ENGLAND\nrighth. , am able to speale the English language.\nKinth\nconsideration of the petition\n: my last\nUmbria otherwise than by veasel, the character of conveyance or nanse of transportation company should be given.)\nthe\non the vessel\n(If\nthe\nthis petition, since the 9 ddy of march anno and Domini in the State 907 of being a residence within this State of as continuously least one year next next preceding preceding the the date date\n9\nalien\narrived\nI have resided July in the United States of America 906 for the term of Ave years at least immediately preceding the date of this patition, to wit, since\nday of\nanno\nDomini\nCalifornia\nforeign residence was Tchernigov Russia\nthis petition.\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nTenth. 1 have not heretofore made petition for eltizenship to any court. (I dade person for do the\nas\nprince, potentate, state, or sovereignty, and particularly to\non the\nday of\nand-th\nsaid patition was assied bu the anid Court for reasons and\nNicholas II, Emperor of all the Russias.\n, of whom I am now a subject;\n1\nand the of denial has sinca haen eured. or zamoned\nPETITION IS HEREBY I\nNNW YORK\nin the\n,\nI arrived at the port of\nAttoched hereto and made part of this petition are my declaration of intention to become oltizon of the United States and the certificate from the Department of Labor, together with\nNWW YORK\non or about the 9th.\nday\nmy and the of the two verifying witnesses thareto, required by law. Wherefore your petitioner prays that he may be admitted . citizon of the United States of America.\nState of\nof\nJuly\nanno Domini 906 : I am not an anarchist: I am not a\ntrue of\npolygamist nor a believer in the practice of polygamy; and it is my intention in good faith\nDes\nCongratzee pendioner.)\nDeclaration of Intention and of Arrival No 1079814 from Department of Labor Ned this 18\nNoma - or petitioner assived la the United States DM\nday\nof\nto become a citizen of the-United States of America and to permanently reside therein:\nPertioner wishes name om Jowa 29, 1906, strike changed to pen out the words reading 'and Ceghificate No. Toget. from\nfrom\nAFFIDAVITS OF PETITIONER AND WITNESSES.\nSo HELP ME GOD.\nto\nSeira (Original Bongatzee agnature of department)\nSTATE OF\nCaunty of Los Angeles\nfrom\nto\nSubscribed and sworn to before me this\n4th\nThe aforesaid being duly deposes and aays that he is the petitioner in the above entitted proceedings; that he has read the foregoing pelition and knows the\nanno Domini 1912\ncontents thereof: that the auld pétition is signed with his full, true name: that the same u true of hie own knowledge, except - to maitera therein stated to be alleged\nday of January\nupon\n[SEAL]\n,\ninformation and bellef, and that to those maitera he believee\nCOUNTY. CLERK. AND EX-OFFLCIO.I GLENK of\nH. J. Lelande\nTHE SUPERIOR COURT IN AND FOR THE COUNTY\nOF LOS ANGELES. STATE OF CALIFORNIA.\nLung Brame as occupation \" to be true. mer Tailor Serve residion sebe (Complote and Pengagon\nClerk of the\nCourt.\nand Astoman Suplin litt. assupation Chemical\nas\nPalding at\nsech Clerk.\nasverally, duly, and repeetively deposse and sage of the United States that\nBy\nimmodiately the date of fling Ma aptition, use the day Crejike of above mestioned, anno he Dominid to has have parsonally known the United State States\npetition to mode alace the\n7\nin the in which the\nday\nof\n- Domina z and that he has personal that\nte of Naturalisation, No.\nthe deld la . person of good charaster, attached to the principles of the Conatidution of the United Statex and that the pottaloner la in - qualifled\nopinion, to be admiticad . of the United\nhavin Beams\nos\nNOLLOVDIO\nAND\nSolomon Supplie\n-\nand de the of the of Court this\nIs\n29 14"
}