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If by ship: N ame of steamship line was
2d 1st cabin cabin
3d cabin
I arrived as (passenger, towaway, seaman, member of crew, or otherwise)
(State which)
I traveled on (an immigration visa, a passport, a permit)
(State which)
I paid
head tax at
, on
(State amount)
(City)
(State or country)
(Month)
(Day)
(Year)
I was examined by immigration officers at
At that time I intended to remain (permanently, temporarily, for visit, in transit)
(State which)
The person in the United States I was coming to was
(Give_name in full)
The place in the United States I was going to was
The names of some of the persons or passengers I traveled with were
said
Choragycha
Palaad
My last place of foreign residence was (City/or town)
(Country)
I am yes married. The name of my
{
wife
is agata Rantoning
She
was born at
husband
, and now resides at
stick
He
nowa Wies Paland
8ml Pleasants normish
I am now a subject of and intend to renounce allegiance to
(Write
Paland name and title of sovereign and the country Republic of high now a subject;
or, if cifizen of a Republic, write name of Republic only)
Poland
I arrived at the United States Immigration port of
new York (City
or town)
new York (State or
, on
June 1904
territory)
(Give exact month, day, and year)
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)
Canada
(b) The place in
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
(A) The place in
where I bought my railroad ticket to come to the United States was
Mexico
Feliks (Signature of applicant)
GOVERNMENT PRENTING offica
e14-8
Parkiaurez
(OVER)
Page data
- Page
- 33
- Source index
- 0
- Type
- photo
- Media ID
- 76fe9890f12c7ef8
- 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 metadata
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Document source extras
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Page context
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"ocrText": "If by ship: N ame of steamship line was\n2d 1st cabin cabin\n3d cabin\nI arrived as (passenger, towaway, seaman, member of crew, or otherwise)\n(State which)\nI traveled on (an immigration visa, a passport, a permit)\n(State which)\nI paid\nhead tax at\n, on\n(State amount)\n(City)\n(State or country)\n(Month)\n(Day)\n(Year)\nI was examined by immigration officers at\nAt that time I intended to remain (permanently, temporarily, for visit, in transit)\n(State which)\nThe person in the United States I was coming to was\n(Give_name in full)\nThe place in the United States I was going to was\nThe names of some of the persons or passengers I traveled with were\nsaid\nChoragycha\nPalaad\nMy last place of foreign residence was (City/or town)\n(Country)\nI am yes married. The name of my\n{\nwife\nis agata Rantoning\nShe\nwas born at\nhusband\n, and now resides at\nstick\nHe\nnowa Wies Paland\n8ml Pleasants normish\nI am now a subject of and intend to renounce allegiance to\n(Write\nPaland name and title of sovereign and the country Republic of high now a subject;\nor, if cifizen of a Republic, write name of Republic only)\nPoland\nI arrived at the United States Immigration port of\nnew York (City\nor town)\nnew York (State or\n, on\nJune 1904\nterritory)\n(Give exact month, day, and year)\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)\nCanada\n(b) The place in\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(A) The place in\nwhere I bought my railroad ticket to come to the United States was\nMexico\nFeliks (Signature of applicant)\nGOVERNMENT PRENTING offica\ne14-8\nParkiaurez\n(OVER)"
}