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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
4994
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
CARD INDEX
upper left-hand corner of all copies of
declaration, immediately under your
INDEX BOOKS
declaration number.
DISTRICT DIRECTOR OF NATURALIZATION.
MANIFESTS
(NOTE TO CLERK OF COURT.-To guide you in preparing the Declaration: The black face lines on this form contain statements
in the regular order as they are to appear on the Declaration of Intention.)
I desire to file my Declaration of Intention (first paper) to become a citizen.
Mr.
My name is
Mrs.
Reymonda liep should print typewrite here Hermose true, original, corroct name)
28
; age,
years.
Miss
or and
(Give age last birthday)
Also known as
(If alien has used any other name in this country, that name should be shown here)
I used that name because
The full name of the person shown on my steamship ticket was,
My mo ther's maiden was
My maiden name was (if woman)
My present occcupation is Ship look second class u.s. C. G.
My personal description is: Color, Brown ; complexion, Dark ; height, 5- feet 3 inches;
weight, 120 pounds; color of hair, Black
; color of eyes,
dark nown
;
other visible distinctive marks: Tattosmarks both leftx right arms
I was born in
manila
(City of town)
Philippine (Country) Islands
on the
1st. day of
My present residence is U.S.C. G. academys new London,
January
1999
korn.
(Number and street)
(City or town)
(County)
(State)
My post office address is
new London, com
The place where I took the ship or train which
landed me in the United States was Manila, P.I.E.C.A.
, on november, (Month) 29 (Day) 1984 (Year)
The ticket on which I camo this country was bought at
The name of the ship or railroad on which I
came was U.S.S. Transport (City) sherman (Country)
(OVER)
014-8
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Document data
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- Core
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- Type
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DTO data
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"ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n4994\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\nCARD INDEX\nupper left-hand corner of all copies of\ndeclaration, immediately under your\nINDEX BOOKS\ndeclaration number.\nDISTRICT DIRECTOR OF NATURALIZATION.\nMANIFESTS\n(NOTE TO CLERK OF COURT.-To guide you in preparing the Declaration: The black face lines on this form contain statements\nin the regular order as they are to appear on the Declaration of Intention.)\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMrs.\nReymonda liep should print typewrite here Hermose true, original, corroct name)\n28\n; age,\nyears.\nMiss\nor and\n(Give age last birthday)\nAlso known as\n(If alien has used any other name in this country, that name should be shown here)\nI used that name because\nThe full name of the person shown on my steamship ticket was,\nMy mo ther's maiden was\nMy maiden name was (if woman)\nMy present occcupation is Ship look second class u.s. C. G.\nMy personal description is: Color, Brown ; complexion, Dark ; height, 5- feet 3 inches;\nweight, 120 pounds; color of hair, Black\n; color of eyes,\ndark nown\n;\nother visible distinctive marks: Tattosmarks both leftx right arms\nI was born in\nmanila\n(City of town)\nPhilippine (Country) Islands\non the\n1st. day of\nMy present residence is U.S.C. G. academys new London,\nJanuary\n1999\nkorn.\n(Number and street)\n(City or town)\n(County)\n(State)\nMy post office address is\nnew London, com\nThe place where I took the ship or train which\nlanded me in the United States was Manila, P.I.E.C.A.\n, on november, (Month) 29 (Day) 1984 (Year)\nThe ticket on which I camo this country was bought at\nThe name of the ship or railroad on which I\ncame was U.S.S. Transport (City) sherman (Country)\n(OVER)\n014-8"
}