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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5163
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
Veronika
I desire to file my Declaration of Intention (first paper) to become a citizen.
My name is
Mr. Mrs. ToriA N. RuszerAs
; age,
45
years.
Miss
(Alien should print or typewrite here true, original, and correct name)
(Give age last birthday)
My
present occupation is
My personal description is: Color, white ; complexion, light
; height, 5
feet 21/2 -inches;
weight, 163 pounds; color of hair, browngray ; color of eyes, flue gray
other visible distinctive marks:
none
I was born in Wala (City town) austria, now (Country) Poland
Sydakorska
or
on the 2nd
day of
Let
1882 viswold,
My present residence is States (Number and are street) (City or town) City," (County) Cour
general
(State)
The where I took the ship or train which landed me in the United States was Bremier
place
on Sept (Month)
-
1895
(Day)
(Year)
The name of the ship or railroad on which I came
was Das not knm
My was
last place of foreign residence sand Wala (City town) Azdakougkag (Country)
or
of
wife
I am
husband
}
, and now resides at Court
is Joseph Ratageta
She
married. The name of my
}
was born at
He
Lithuania
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;
Poland
or, if citizen of a republic, write name of republic only)
I arrived at the United States immigration port of new York (City or
town)
n.y. State or territory)
on
October
, 1895
,
14-8
(Give exact month, day, and year)
(OVER)
Page data
- Page
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- Source index
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- Type
- photo
- Media ID
- cd9c000e91ec0d20
- 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": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5163\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\nVeronika\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMy name is\nMr. Mrs. ToriA N. RuszerAs\n; age,\n45\nyears.\nMiss\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nMy\npresent occupation is\nMy personal description is: Color, white ; complexion, light\n; height, 5\nfeet 21/2 -inches;\nweight, 163 pounds; color of hair, browngray ; color of eyes, flue gray\nother visible distinctive marks:\nnone\nI was born in Wala (City town) austria, now (Country) Poland\nSydakorska\nor\non the 2nd\nday of\nLet\n1882 viswold,\nMy present residence is States (Number and are street) (City or town) City,\" (County) Cour\ngeneral\n(State)\nThe where I took the ship or train which landed me in the United States was Bremier\nplace\non Sept (Month)\n-\n1895\n(Day)\n(Year)\nThe name of the ship or railroad on which I came\nwas Das not knm\nMy was\nlast place of foreign residence sand Wala (City town) Azdakougkag (Country)\nor\nof\nwife\nI am\nhusband\n}\n, and now resides at Court\nis Joseph Ratageta\nShe\nmarried. The name of my\n}\nwas born at\nHe\nLithuania\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;\nPoland\nor, if citizen of a republic, write name of republic only)\nI arrived at the United States immigration port of new York (City or\ntown)\nn.y. State or territory)\non\nOctober\n, 1895\n,\n14-8\n(Give exact month, day, and year)\n(OVER)"
}