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Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 4923 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 (NOTE TO CLERK OF COURT.-To guide you in preparing the Declaration: The black face lines on this form contain statements in the regular order as they are to appear on the Declaration of Intention.) I desire to file my Declaration of Intention (first paper) to become a citizen. Mr. My name is Mrs. JOSEPH MATHEW SCHLECHT: age, 34 years. Miss (Alien should print or typewrite here true, original, and correct name) (Give age last birthday) Also known as (If alien has used any other name in this country, that name should be shown here) I used that name because The full name of the person shown on my steamship ticket was My mother S maiden name was My maiden name was (if woman) My personal description is: Color, white ; complexion, fair My present occcupation is Loomfixer ; height, 5 feet 4 inches; weight, 160 pounds; color of hair, brownd ; color of eyes, brown ; other visible distinctive marks: Scarsonbacks of left austria middleaud I was borm in (City or town) (Country) on the 27 day My present residence is 19 newfondon Conn. of august , 1892 (Number and street) (City or town) (County) (State) My post office address is 19 meridian St new boudm Come The place where I took the ship or train which landed me in the United States was Bremen Germany , on 1896 (Month) (Day) (Year) The ticket on which I camo to this country was bought at The name of the ship or railroad on which I came was (City) know (Country ol (OVER)

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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n4923\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\n(NOTE TO CLERK OF COURT.-To guide you in preparing the Declaration: The black face lines on this form contain statements\nin the regular order as they are to appear on the Declaration of Intention.)\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMr.\nMy name is\nMrs.\nJOSEPH MATHEW SCHLECHT: age,\n34\nyears.\nMiss\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nAlso known as\n(If alien has used any other name in this country, that name should be shown here)\nI used that name because\nThe full name of the person shown on my steamship ticket was\nMy mother S maiden name was\nMy maiden name was (if woman)\nMy personal description is: Color, white ; complexion, fair\nMy present occcupation is Loomfixer\n; height, 5 feet 4 inches;\nweight, 160 pounds; color of hair, brownd\n;\ncolor of eyes, brown\n;\nother visible distinctive marks: Scarsonbacks of left austria middleaud\nI was borm in (City\nor town)\n(Country)\non the 27\nday\nMy present residence is 19 newfondon Conn.\nof august\n, 1892\n(Number and street)\n(City or town)\n(County)\n(State)\nMy post office address is 19 meridian St new boudm Come\nThe place where I took the ship or train which landed me in the United States was\nBremen\nGermany\n, on\n1896\n(Month)\n(Day)\n(Year)\nThe ticket on which I camo to this country was bought at\nThe name of the ship or railroad on which I came was\n(City) know (Country ol\n(OVER)"
}