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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5385
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 citizen.
Mr.
My name is
Mrs.
|
alefasander Gerylewing
; age,
43
years.
(Alen should print typewrite here true, original, and name)
or correct
(Give age last birthday)
My present occupation Miss is laborer
My personal description is: Color, white ; complexion, fair
; height, 5 feet 9
inches;
weight, 165 pounds; color of hair, brown
; color of eyes,
blue
;
other visible distinctive marks: Scarsonbackohueck
I
was born in Koscienmiter,Autor now ,Poland
on the 5th
(City or town)
(Country)
day of
april
1885
,
My
present residence is Nucasville montville Connecticut
(Number and street)
(dity or town)
(County)
(State)
The place where I took the ship or train which landed me in the United States was Sault Ste
Marie, Canada ,
on
(Monm)
(Day)
(Year)
The name of the ship or railroad on which I came was farryboat
My
last place of foreign residence was said Sault/ste Marie
(City or town)
wife
I am
married. The name of my
is anna
(Country)
She
was born at
husband
He
Jablonow am now a subject of and intend Poland to renounce allegiance , and now to resides the at Borszezon, (Write Republic of and title of sovereign and Poland of which subject;
Poland
name country now a
or, if citizen of a republic, write name of republic only)
I arrived at the United States immigration
port of sault Ste Marie
(City or lown)
Michigan
, on march 14,1917
(State or territory)
14--8
(Give exact month; day, and year)
(OVER)
Page data
- Page
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- Source index
- 0
- Type
- photo
- Media ID
- 5cf832df40b293be
- 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\n5385\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 citizen.\nMr.\nMy name is\nMrs.\n|\nalefasander Gerylewing\n; age,\n43\nyears.\n(Alen should print typewrite here true, original, and name)\nor correct\n(Give age last birthday)\nMy present occupation Miss is laborer\nMy personal description is: Color, white ; complexion, fair\n; height, 5 feet 9\ninches;\nweight, 165 pounds; color of hair, brown\n; color of eyes,\nblue\n;\nother visible distinctive marks: Scarsonbackohueck\nI\nwas born in Koscienmiter,Autor now ,Poland\non the 5th\n(City or town)\n(Country)\nday of\napril\n1885\n,\nMy\npresent residence is Nucasville montville Connecticut\n(Number and street)\n(dity or town)\n(County)\n(State)\nThe place where I took the ship or train which landed me in the United States was Sault Ste\nMarie, Canada ,\non\n(Monm)\n(Day)\n(Year)\nThe name of the ship or railroad on which I came was farryboat\nMy\nlast place of foreign residence was said Sault/ste Marie\n(City or town)\nwife\nI am\nmarried. The name of my\nis anna\n(Country)\nShe\nwas born at\nhusband\nHe\nJablonow am now a subject of and intend Poland to renounce allegiance , and now to resides the at Borszezon, (Write Republic of and title of sovereign and Poland of which subject;\nPoland\nname country now a\nor, if citizen of a republic, write name of republic only)\nI arrived at the United States immigration\nport of sault Ste Marie\n(City or lown)\nMichigan\n, on march 14,1917\n(State or territory)\n14--8\n(Give exact month; day, and year)\n(OVER)"
}