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Form 2203 TRIPLICATE U. S. DEPARTMENT OF LABOR [To be given le the person making 5064 NATURALIZATION SERVICE the Declaration) No. 2581 STATES OF DECLARATION OF INTENTION Invalid for all purposes seven years after the date hereof State of Connectiout In the Superior Court SS : County of Now London of New London County u, Franois Raymond Haley aged 57 64 years, occupation college professor , do declare on oath that my personal description is: Color 1/2 white , complexion blond , height 5 feet 6 inches, weight 140 pounds, color of hair mixed brown , color of eyes blue other visible distinctive marks none I was born in Yarmouth, Nova Scot ia, Canada on the 24th day of August , anno Domini I 862 ; I now reside at 249 Broadway Norwich, Connectic (Give number, street, city or town, and State) I emigrated to the United States of America from Wolfville, Nova Scotia on the vessel Canadian Pacific Bailway ; my last (Ifthealien arrived otherwise than by vessel, the character of conveyance or name of transportation company should be given) foreign residence was Wolfvillo, Nova Scotia ; I am married; the name of my wife is Elizabeth ; she was born at Preston, Connecticut, and now resides at/ aid 249 Broadway, Horwi ch, Connecticut. It is my bona fide intention to renounce forever all allegiance and fidelity to any foreign prince, potentate, state, or sovereignty, and particularly to George V, King of Great Britain- and Ireland NC 1 arrived at the port of Venceboro balars of whom I am now a subject; , in the State of Maine on or about the of 919 19th 21sta day June august anno Domini I 916 ; 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: So HELP ME GOD. Francis (Original signatury Reymond declarant) stalez of Subscribed and sworn to before me in the office of the Clerk of said Court this 22nd day of September , anno Domini 191 George E.Parsons- Clerk of the Superior Court. Bythibbend R. Norman , Assistant Clerk. 14--1170

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    "ocrText": "Form 2203\nTRIPLICATE\nU. S. DEPARTMENT OF LABOR\n[To be given le the person making\n5064\nNATURALIZATION SERVICE\nthe Declaration)\nNo. 2581\nSTATES OF\nDECLARATION OF INTENTION\nInvalid for all purposes seven years after the date hereof\nState of Connectiout\nIn the\nSuperior\nCourt\nSS :\nCounty of Now London\nof\nNew London County\nu,\nFranois Raymond Haley\naged 57 64 years,\noccupation\ncollege professor\n,\ndo declare on oath that my personal\ndescription is: Color\n1/2\nwhite\n,\ncomplexion blond\n,\nheight 5 feet 6 inches,\nweight 140\npounds, color of hair mixed brown , color of eyes blue\nother visible distinctive marks\nnone\nI was born in\nYarmouth, Nova Scot ia, Canada\non the 24th\nday of\nAugust\n, anno Domini I 862 ; I now reside\nat\n249 Broadway Norwich, Connectic\n(Give number, street, city or town, and State)\nI emigrated to the United States of America from Wolfville, Nova Scotia\non the vessel\nCanadian Pacific Bailway\n; my last\n(Ifthealien arrived otherwise than by vessel, the character of conveyance or name of transportation company should be given)\nforeign residence was Wolfvillo, Nova Scotia\n; I am\nmarried; the name\nof my wife is Elizabeth\n;\nshe was born at Preston, Connecticut,\nand now resides at/ aid 249 Broadway, Horwi ch, Connecticut.\nIt is my bona fide intention to renounce forever all allegiance and fidelity to any foreign\nprince, potentate, state, or sovereignty, and particularly to George V, King of Great\nBritain- and Ireland NC\n1 arrived at the port of\nVenceboro balars\nof whom I am now a subject;\n, in the\nState of\nMaine\non or about the\nof\n919\n19th 21sta day\nJune august anno Domini I 916 ; I am not an anarchist; I am not\na\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:\nSo HELP ME GOD.\nFrancis (Original signatury Reymond declarant) stalez\nof\nSubscribed and sworn to before me in the office of the Clerk of\nsaid Court this 22nd day of September , anno Domini 191\nGeorge E.Parsons-\nClerk of the\nSuperior\nCourt.\nBythibbend R. Norman\n,\nAssistant Clerk.\n14--1170"
}