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Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 5274 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 upper left-hand corner of all copies of CARD INDEX declaration, immediately under your INDEX BOOKS declaration number. DISTRICT DIRECTOR OF NATURALIZATION MANIFESTS Carmo I desire to file my Declaration of Intention (first paper) to become a citizen. Mr. My name is Mrs. / Kincenz. (Alien should print typewrite Carino here true, original, and ; age, 32 years. or correct name) (Give age last birthday) Miss My present occupation is Cleaning My personal description is: Color, white Daynethark complexion, ; height, 5 feet 3 1/2 inches; weight, 131 pounds; color of hair, darkbrown ; color of eyes, brown ; other visible distinctive marks: of nose I was born in the 18th day of (City ontown) (Country) september stally on , 1890 My present residence is 63 Belder it newLorder n.L. Canne (Number and street) (City or town) (County) les (State) The place I took ship which landed in the United States napot Staby where the or train me was , The name of the ship or railroad on which I came was Jeuiciatenncia on dignide (Month) 15 (Day) 1902 (Year) My last place of foreign was residence sand Avelino (Country) management (City or town) wife is many Coning She I am married. The name of my } was born at paymana husband He sapins , and now sand resides at 63 Belders st I am now a of and to renounce to subject intend allegiance King Write amand title of sovereign and country name and of which now a subject; or, a name only) Staley if citizen of republic, write of republic I arrived at the United States immigration port of (City or town) new york newyounch , (State or territory) on may 14-8 (Give exact 5th month, day, and year) 1909 (OVER)

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798
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Document data

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Core
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Type
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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5274\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\nupper left-hand corner of all copies of\nCARD INDEX\ndeclaration, immediately under your\nINDEX BOOKS\ndeclaration number.\nDISTRICT DIRECTOR OF NATURALIZATION\nMANIFESTS\nCarmo\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMrs.\n/\nKincenz. (Alien should print typewrite Carino here true, original, and\n; age, 32\nyears.\nor correct name)\n(Give age last birthday)\nMiss\nMy present occupation is Cleaning\nMy personal description is: Color, white Daynethark complexion,\n;\nheight, 5 feet 3 1/2 inches;\nweight, 131 pounds; color of hair, darkbrown ; color of eyes, brown\n;\nother visible distinctive marks: of nose\nI was born in\nthe 18th day of\n(City ontown) (Country)\nseptember\nstally\non\n, 1890\nMy present residence is\n63 Belder it newLorder n.L. Canne\n(Number and street)\n(City or town)\n(County)\nles\n(State)\nThe place I took ship which landed in the United States napot Staby\nwhere the or train me was\n,\nThe name of the ship or railroad on which I came was Jeuiciatenncia\non dignide (Month) 15 (Day) 1902 (Year)\nMy last place of foreign was\nresidence sand Avelino (Country)\nmanagement\n(City or town)\nwife\nis many Coning\nShe\nI am\nmarried. The name of my\n}\nwas born at\npaymana\nhusband\nHe\nsapins\n, and now sand resides at 63 Belders st\nI am now a of and to renounce to\nsubject intend allegiance King Write amand title of sovereign and country\nname and of which now a subject;\nor, a name only)\nStaley if citizen of republic, write of republic\nI\narrived at the United States immigration port of (City or town)\nnew york\nnewyounch\n,\n(State or territory)\non may 14-8 (Give exact 5th month, day, and year) 1909\n(OVER)"
}