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I have
used another name in this country than that given at the beginning of this form. If so, it was
I used that name because
The full of the person shown my steamship ticket
name on was
My mother's name was
maiden E len
My maiden name was (if woman)
My post-office address is
present St- Noreigh Comm:
The ticket on which I came to this country was bought at
(City)
(Country)
If arrival by ship: Name of steamship : line was white Stanfine
1st cabin
2d cabin
3d cabin
30
I arrived as (passenger, stowaway, seaman, member of crew, or otherwise)
Passenger.
(State which)
I traveled on (an immigration visa, a passport, a permit)
passport
(State which)
I paid
(State amount)
head tax at questions (City)
,on
(State or country)
(Month)
(Day)
(Year)
I
was examined by immigration officers at questorm
At that time I intended to remain (permanently, temporarily, for visit, in transit) (State which)
The person was coming was
in the United States I to mis ES Enwards
promonemity
(Give name in full)
The place in the United States I was going to was
Norrah Com
The names some or were
of of the persons passengers I traveled with mr John Cheir
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 Boston
-
(e) If not examined, state why, and give the circumstances of your entry
{
Canada
f The place in
Mexico
where I bought my railroad ticket to come to the United States was
Nora Beiley
GOVERNMENT PRENTING OFFICE 14-8
(OVER)
(Signature of applicant)
Page data
- Page
- 815
- Source index
- 0
- Type
- photo
- Media ID
- 31e517e3b4491316
- Size
- unknown
Document data
- ID
- 159596813
- Core
- doc
- Type
- document
DTO data
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"contentType": "document",
"title": "File numbers 4874 - 5509, 1926-1930",
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Context sent to Scholar
Document identity
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"core": "doc",
"dtoType": "document",
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}
Document source metadata
{
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"Applications for Declaration of Intention"
],
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Document source extras
{
"url": "https://catalog.archives.gov/id/159596813",
"naId": 159596813,
"levelOfDescription": "fileUnit",
"onlineResources": [
{
"description": "FamilySearch",
"note": "This file was scanned as part of a collaboration effort between FamilySearch and the National Archives.",
"url": "https://www.familysearch.org/search/catalog/results?count=20&query=%2Bkeywords%3A4526886%20%2Bkeywords%3ANational%20%2Bkeywords%3AArchives"
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],
"recordType": "description",
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Page context
{
"seq": 815,
"pageIndex": 0,
"type": "photo",
"url": "https://s3.amazonaws.com/NARAprodstorage/lz/partnerships-0002/18-0177_US-MA/18-0177_US-MA_21/18-0177_US-MA_-4526886-CTN-Applications-for-Declaration-of--1926-1930/18-0177_US-MA_-4526886-CTN-Applications-for-Declaration-of--1926-1930_00815.jpg",
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"ocrText": "I have\nused another name in this country than that given at the beginning of this form. If so, it was\nI used that name because\nThe full of the person shown my steamship ticket\nname on was\nMy mother's name was\nmaiden E len\nMy maiden name was (if woman)\nMy post-office address is\npresent St- Noreigh Comm:\nThe ticket on which I came to this country was bought at\n(City)\n(Country)\nIf arrival by ship: Name of steamship : line was white Stanfine\n1st cabin\n2d cabin\n3d cabin\n30\nI arrived as (passenger, stowaway, seaman, member of crew, or otherwise)\nPassenger.\n(State which)\nI traveled on (an immigration visa, a passport, a permit)\npassport\n(State which)\nI paid\n(State amount)\nhead tax at questions (City)\n,on\n(State or country)\n(Month)\n(Day)\n(Year)\nI\nwas examined by immigration officers at questorm\nAt that time I intended to remain (permanently, temporarily, for visit, in transit) (State which)\nThe person was coming was\nin the United States I to mis ES Enwards\npromonemity\n(Give name in full)\nThe place in the United States I was going to was\nNorrah Com\nThe names some or were\nof of the persons passengers I traveled with mr John Cheir\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) (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 Boston\n-\n(e) If not examined, state why, and give the circumstances of your entry\n{\nCanada\nf The place in\nMexico\nwhere I bought my railroad ticket to come to the United States was\nNora Beiley\nGOVERNMENT PRENTING OFFICE 14-8\n(OVER)\n(Signature of applicant)"
}