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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5403
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.
Emory Ellis, Rogers
; age,
30
years.
Miss
(Alien, should prift or typewrite here true, original, and correct name)
(Give age last birthday)
My personal description is: Color, Blown (complexion, Brown ; height, 5 feet 7112 6 inches;
My present occupation
is fisherman
weight, 166 pounds; color of hair, Black
; color of eyes, dark brown
other visible distinctive marks: mole on rights cheek and left nostrel
I
was born in anguilla (City or town) B. W.
It,
(Country)
on the
6
day
of December
My present residence is 21 Walbach (Number and street) st now (City or town) Lon; N.L. (County) Conn (State)
1897
The place where I took the
ship or Srain which landed me in the United States was Southampton. Eng:
/ to 18 , on Date, (Month) Mas: or april (Day) * 1919 (Year)
The name of the ship or railroad on which I came was Mauretania
My last place of foreign residence was (City town) Camp (Country) R.W.F 3rd
England
Repatrations
or
I am not married. The name of my
wife
She
is
was born at
husband
He
, and now resides at
,
I subject of and intend allegiance Freat Brittain and Ireland
am now a to renounce to
(Write name and title of sovereign and country of which now a subject;
Eap: or, ifcitizen of King republic, write Seorge. republi only)
a name of
I at
arrived the United States immigration port of new york City (City town)
or
,
(State or territory)
on april 14-8 (Give exact month, day, 1919 and year)
(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
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DTO data
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Context sent to Scholar
Document identity
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"ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5403\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.\nEmory Ellis, Rogers\n; age,\n30\nyears.\nMiss\n(Alien, should prift or typewrite here true, original, and correct name)\n(Give age last birthday)\nMy personal description is: Color, Blown (complexion, Brown ; height, 5 feet 7112 6 inches;\nMy present occupation\nis fisherman\nweight, 166 pounds; color of hair, Black\n; color of eyes, dark brown\nother visible distinctive marks: mole on rights cheek and left nostrel\nI\nwas born in anguilla (City or town) B. W.\nIt,\n(Country)\non the\n6\nday\nof December\nMy present residence is 21 Walbach (Number and street) st now (City or town) Lon; N.L. (County) Conn (State)\n1897\nThe place where I took the\nship or Srain which landed me in the United States was Southampton. Eng:\n/ to 18 , on Date, (Month) Mas: or april (Day) * 1919 (Year)\nThe name of the ship or railroad on which I came was Mauretania\nMy last place of foreign residence was (City town) Camp (Country) R.W.F 3rd\nEngland\nRepatrations\nor\nI am not married. The name of my\nwife\nShe\nis\nwas born at\nhusband\nHe\n, and now resides at\n,\nI subject of and intend allegiance Freat Brittain and Ireland\nam now a to renounce to\n(Write name and title of sovereign and country of which now a subject;\nEap: or, ifcitizen of King republic, write Seorge. republi only)\na name of\nI at\narrived the United States immigration port of new york City (City town)\nor\n,\n(State or territory)\non april 14-8 (Give exact month, day, 1919 and year)\n(OVER)"
}