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File numbers 4874 - 5509, 1926-1930

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I have used another name in this country than that given at the beginning of this form. If so, it was JACQUES, I used that name because IT IS MY CONFIRMATION NAME The full name of the person shown on my steamship ticket was JOHN SOUKUP, My mother's maiden name was ANNA KORKA, My maiden name was (if woman) My post-office address is LYME CONNECTICUT. 2 The ticket on which I came to this country was bought at BREMEN, GERMANY, (City) (Country) 1st cabin If arrival by ship: Name of steamship line was NORTH GER. LOYLD 2d cabin 2d CABIN. 3d cabin I arrived as (passenger, stowaway, seaman, member of crew, or otherwise) PASSENGER, (State which) I traveled on (an immigration visa, a passport, a permit) PASSPORT, (State which) I paid head tax at ,on (State amount) (City) E (State or country) (Month) (Day) (Year) I was examined by immigration officers at BREMEN, HOBOKEN, At that time I intended to remain (permanently, temporarily, for visit, in transit) PERMANENTLY. (State which) The person in the United States I was coming to was FRANK DUSEK, (Give name in full) The place in the United States I was going to was NEW YORK CITY. The names of some of the persons or passengers I traveled with were MY PARENTS. ADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME FROM OR THROUGH CANADA OR MEXICO: (a) The place in Canada where I landed was , on (Month) (Day) (Year) (b) The place in { Canada from which I entered the United States was Mexico (c) On (Month) (Day) (Year) (d) The place where I was examined for admission at the United States border was (e) If not examined, state why, and give the circumstances of your entry Canada (f) The place in Mexico where I bought my railroad ticket to come to the United States was GOVERNMENT PRINTING OFTION 14-8 (OVER) (Signature of applicant)

Page data

Page
1055
Source index
0
Type
photo
Media ID
34bd275a4df20d7b
Size
unknown

Document data

ID
159596813
Core
doc
Type
document
DTO data 
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Context sent to Scholar

Document identity 
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Document source extras 
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Page context 
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    "ocrText": "I have\nused another name in this country than that given at the beginning of this form. If so, it was\nJACQUES,\nI used that name because\nIT IS MY CONFIRMATION NAME\nThe full name of the person shown on my steamship ticket was\nJOHN SOUKUP,\nMy mother's maiden name was\nANNA KORKA,\nMy maiden name was (if woman)\nMy post-office address is\nLYME CONNECTICUT.\n2\nThe ticket on which I came to this country was bought at\nBREMEN,\nGERMANY,\n(City)\n(Country)\n1st cabin\nIf arrival by ship: Name of steamship line was\nNORTH GER. LOYLD\n2d cabin\n2d CABIN.\n3d cabin\nI arrived as (passenger, stowaway, seaman, member of crew, or otherwise)\nPASSENGER,\n(State which)\nI traveled on (an immigration visa, a passport, a permit)\nPASSPORT,\n(State which)\nI paid\nhead tax at\n,on\n(State amount)\n(City)\nE\n(State or country)\n(Month)\n(Day)\n(Year)\nI was examined by immigration officers at\nBREMEN, HOBOKEN,\nAt that time I intended to remain (permanently, temporarily, for visit, in transit)\nPERMANENTLY.\n(State which)\nThe person in the United States I was coming to was\nFRANK DUSEK,\n(Give name in full)\nThe place in the United States I was going to was NEW YORK CITY.\nThe names of some of the persons or passengers I traveled with were\nMY PARENTS.\nADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME FROM OR THROUGH CANADA OR MEXICO:\n(a) The place in Canada where I landed was\n, on\n(Month)\n(Day)\n(Year)\n(b) The place in\n{\nCanada\nfrom which I entered the United States was\nMexico\n(c) On\n(Month)\n(Day)\n(Year)\n(d) The place where I was examined for admission at the United States border was\n(e) If not examined, state why, and give the circumstances of your entry\nCanada\n(f) The place in\nMexico\nwhere I bought my railroad ticket to come to the United States was\nGOVERNMENT PRINTING OFTION 14-8\n(OVER)\n(Signature of applicant)"
}