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Form
TRIPLICATE
1 to
(To be making
the Declaration)
No.
21
bject
STATES
OF
at
all
and
Department of Conmerce and Tabor
Kindl
BUREAU OF IMMIGRATION AND NATURALIZATION
DIVISION OF NATURALIZATION
1
DECLARATION OF INTENTION
Clerk,
(Invalid for all purposes seven years after the date hereof)
buly
State of Oalifornia,
In the
Superier
Court
SS:
Gounty of San Diege.
of
San Diege, California,
)
ort thereof, and
by is, admitted
3.
Themas Alfred Wormingten
aged
48
years,
occupation
Rancher
do declare affirm on oath that my personal
at his name be,
description is: Color White
complexion Light
, height 6 feet 6 inches,
an act entitled
weight 135 pounds, color of hair Dark brom color of eyes
Brown
iens throughout
other visible distinctive marks
Nene
judge
;
I was born in
England
on the
7th
day of
July
anno
Domini I -858 ; I now reside at
San Diege, california.
I emigrated to the United States of America from
Ingland
: my last
on the vessel
[If
the allen arrived otherwise than by Oceanic vessel. the character of conveyance or name of transportation company should be given.]
8 of America.
foreign residence was
Ingland
It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign
, calif
prince, potentate, state, or sovereignty, and particularly to
Edward VII
is, calif
, of which I am now a citizen subject I
e
King of Great Britain and Ireland
, in the
usly immediately
arrived at the port of
New York
liately preceding
State
institution of the
Territory of
New York
on or about the
24th
day
District
les
of
October
, anno Domini I-905 : 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 :
Clerk,
my
Oterli,
So HELP ME GOD.
I homas alfed Wormington declafant.)
(Original signature of
Subscribed and affirmed swern to before me this
18th
day of
March
anno Domini 19 or
Im. H. Francia
Superier
Court.
Clerk of the
By or Wirttrancis
Deputy Clerk.
11-9598
Page data
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- Type
- photo
- Media ID
- 9adf2078ae1d7143
- Size
- unknown
Document data
- ID
- 103904445
- Core
- doc
- Type
- document
DTO data
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Context sent to Scholar
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Page context
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"ocrText": "Form\nTRIPLICATE\n1 to\n(To be making\nthe Declaration)\nNo.\n21\nbject\nSTATES\nOF\nat\nall\nand\nDepartment of Conmerce and Tabor\nKindl\nBUREAU OF IMMIGRATION AND NATURALIZATION\nDIVISION OF NATURALIZATION\n1\nDECLARATION OF INTENTION\nClerk,\n(Invalid for all purposes seven years after the date hereof)\nbuly\nState of Oalifornia,\nIn the\nSuperier\nCourt\nSS:\nGounty of San Diege.\nof\nSan Diege, California,\n)\nort thereof, and\nby is, admitted\n3.\nThemas Alfred Wormingten\naged\n48\nyears,\noccupation\nRancher\ndo declare affirm on oath that my personal\nat his name be,\ndescription is: Color White\ncomplexion Light\n, height 6 feet 6 inches,\nan act entitled\nweight 135 pounds, color of hair Dark brom color of eyes\nBrown\niens throughout\nother visible distinctive marks\nNene\njudge\n;\nI was born in\nEngland\non the\n7th\nday of\nJuly\nanno\nDomini I -858 ; I now reside at\nSan Diege, california.\nI emigrated to the United States of America from\nIngland\n: my last\non the vessel\n[If\nthe allen arrived otherwise than by Oceanic vessel. the character of conveyance or name of transportation company should be given.]\n8 of America.\nforeign residence was\nIngland\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\n, calif\nprince, potentate, state, or sovereignty, and particularly to\nEdward VII\nis, calif\n, of which I am now a citizen subject I\ne\nKing of Great Britain and Ireland\n, in the\nusly immediately\narrived at the port of\nNew York\nliately preceding\nState\ninstitution of the\nTerritory of\nNew York\non or about the\n24th\nday\nDistrict\nles\nof\nOctober\n, anno Domini I-905 : 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 :\nClerk,\nmy\nOterli,\nSo HELP ME GOD.\nI homas alfed Wormington declafant.)\n(Original signature of\nSubscribed and affirmed swern to before me this\n18th\nday of\nMarch\nanno Domini 19 or\nIm. H. Francia\nSuperier\nCourt.\nClerk of the\nBy or Wirttrancis\nDeputy Clerk.\n11-9598"
}