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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5190
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
I desire to file my Declaration of Intention (first paper) to become a
Hrsula anna Bandroff citizen
Mr.
My name is
Mrs.
mas anna nandrow
; age,
43
years.
Miss
(Alienshould print or typewrite here true, original, and correct name)
(Give age last birthday)
My present occupation is
hoursonan he wife
My personal description is: Color, white ; complexion, fair
; height,
$4, feet 11 inches;
weight, 130 pounds; color of hair. dark brown color of eyes, blue
;
other visible distinctive marks:
none
Pockmarkson face
I was born
in (City or town) Russia, Russ now Poland (Country)
Burbany
on the
day
of June
, 884
My present
residence is 26 Sixth stu new London, Conn.
(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 Rotterdaman
Holland
Ryndain on July not (Month) 6
MARK
(Day
1906
(Year)
The name of the ship or railroad on whick I came was A remember
said
My last place of foreign residence was
A
Burbany
Russ Poland
(City or town)
wifo
I am
married. The name of my
is
poperator Bandrod (Country)
She
was born at
husband
Galicia, Paland
paid
He
, and now resides at
26 sixth str. new handon
I am now a subject of and intend to renounce allegiance to
Republic Paland subject;
Conn.
(Write name and title of sovereign and country of which now a
or, if citizen of a republic, write name of republic only)
I arrived at the United States immigration port of
new york, (City N.4
/town)
q
, on
(State or territory)
about 14-8 July (dive exaet month, day, to , and year) 1906 .
(OVER)
Page data
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- Source index
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- Type
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- Size
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Document data
- ID
- 159596813
- Core
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- Type
- document
DTO data
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"ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5190\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\nI desire to file my Declaration of Intention (first paper) to become a\nHrsula anna Bandroff citizen\nMr.\nMy name is\nMrs.\nmas anna nandrow\n; age,\n43\nyears.\nMiss\n(Alienshould print or typewrite here true, original, and correct name)\n(Give age last birthday)\nMy present occupation is\nhoursonan he wife\nMy personal description is: Color, white ; complexion, fair\n; height,\n$4, feet 11 inches;\nweight, 130 pounds; color of hair. dark brown color of eyes, blue\n;\nother visible distinctive marks:\nnone\nPockmarkson face\nI was born\nin (City or town) Russia, Russ now Poland (Country)\nBurbany\non the\nday\nof June\n, 884\nMy present\nresidence is 26 Sixth stu new London, Conn.\n(Number and street)\n(City or town)\n(County)\n(State)\nThe\nplace where I took the ship or train which landed me in the United States was Rotterdaman\nHolland\nRyndain on July not (Month) 6\nMARK\n(Day\n1906\n(Year)\nThe name of the ship or railroad on whick I came was A remember\nsaid\nMy last place of foreign residence was\nA\nBurbany\nRuss Poland\n(City or town)\nwifo\nI am\nmarried. The name of my\nis\npoperator Bandrod (Country)\nShe\nwas born at\nhusband\nGalicia, Paland\npaid\nHe\n, and now resides at\n26 sixth str. new handon\nI am now a subject of and intend to renounce allegiance to\nRepublic Paland subject;\nConn.\n(Write name and title of sovereign and country of which now a\nor, if citizen of a republic, write name of republic only)\nI arrived at the United States immigration port of\nnew york, (City N.4\n/town)\nq\n, on\n(State or territory)\nabout 14-8 July (dive exaet month, day, to , and year) 1906 .\n(OVER)"
}