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Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 5431 U. S. DEPARTMENT OF LABOR NOT TO BE FILLED IN BY ALIEN FOR USE OF OFFICIALS SEARCHING IMMI- NATURALIZATION SERVICE GRATION RECORDS CLERK OF COURT: RECORDS EXAMINED Place number in upper left-hand corner of all copies of CARD INDEX declaration, immediately under your INDEX BOOKS declaration number. DISTRICT DIRECTOR OF NATURALIZATION MANIFESTS I desire to file my Declaration of Intention (first paper) to become a citizen. Mr. My name is Mrs. mrs ; age, 51 years. Miss (Alien should print or typewrike here true, original, and correct name) (Give age last birthday) My present occupation is cook My personal description is: Color, Fair ; height, 5 feet 8 inches; weight, 170 pounds; color of hair, color of eyes, Gray ; other visible distinctive marks: I was born in Edovalla Breek Smeden (City or town) (Country) on the 19 yuly day of 1877 , ,1 My present residence is 285 Broad st Graten leann (Number and street) (City or town) (County) (State) The place where I took the ship or train which landed me in the United States was Gutten on July 93 1893 (Month) (Day) (Year) The name of the ship or on which I came was etcery My last place of foreign residence was Edsuacia Bruck (Country swedted (City or town) wife She I am married. The name of my is T was born at husband and now resides at (fresent He unknown) I am now a subject of and intend to renounce allegiance to (Write name and title of sovereign and country of which now a subject; I or, arrived citizen at of the republic, United write States of republic immigration only) port of anyunt 311893 (City or town) new York if a name , on (State or territory) 14-8 (Give exact month, day, and year) (OVER)

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1124
Source index
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Type
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Document data

ID
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Core
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Type
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Document identity
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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5431\nU. S. DEPARTMENT OF LABOR\nNOT TO BE FILLED IN BY ALIEN\nFOR USE OF OFFICIALS SEARCHING IMMI-\nNATURALIZATION SERVICE\nGRATION RECORDS\nCLERK OF COURT:\nRECORDS EXAMINED\nPlace number\nin\nupper left-hand corner of all copies of\nCARD INDEX\ndeclaration, immediately under your\nINDEX BOOKS\ndeclaration number.\nDISTRICT DIRECTOR OF NATURALIZATION\nMANIFESTS\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMrs.\nmrs\n; age,\n51\nyears.\nMiss\n(Alien should print or typewrike here true, original, and correct name)\n(Give age last birthday)\nMy present occupation is\ncook\nMy personal description is: Color,\nFair\n; height, 5 feet 8 inches;\nweight, 170 pounds; color of hair, color of eyes, Gray\n;\nother\nvisible distinctive marks:\nI was born in\nEdovalla Breek\nSmeden\n(City or town)\n(Country)\non the 19 yuly day of\n1877\n, ,1\nMy present residence is\n285 Broad st\nGraten leann\n(Number and street)\n(City or town)\n(County)\n(State)\nThe place where I took the ship or train which landed me in the United States was\nGutten on\nJuly\n93\n1893\n(Month)\n(Day)\n(Year)\nThe\nname of the ship or on which I came was etcery\nMy last place of foreign residence was\nEdsuacia Bruck (Country swedted\n(City or town)\nwife\nShe\nI am\nmarried. The name of my\nis\nT\nwas born at\nhusband and now resides at (fresent He unknown)\nI am now a subject of and intend to renounce allegiance to\n(Write name and title of sovereign and country of which now a subject;\nI or, arrived citizen at of the republic, United write States of republic immigration only) port of anyunt 311893 (City or town) new York\nif a name\n, on\n(State or territory)\n14-8\n(Give exact month, day, and year)\n(OVER)"
}