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I have notuced this than another name in country that given at the beginning of this form. If so, it was I used that name because - The name on was full of the person shown my steamship ticket Jacob Butberg My mother's maiden name was Eva Luchansky My maidon name was (if woman) My post-office 125 montank ave., Seen Longton Can address is The ticket on which I came to this country was bought at Bremen (City) permany (Country) If was arrival by ship: Name of steamship line Bremen American 1st cabin 2d cabin Co. a 3d cabin I as or arrived (passenger, stowaway, seaman, member of crew, otherwise) (State which) passings I traveled on (an immigration visa, a passport, a permit) passport (State which) I paid no head tax at , on (State amount) (City) (State or country) (Month) (Day) (Year) I was examined by immigration officers at Ellis n. y Island, At that time I intended to remain (permanently, temporarily, for visit, in transit) (State which) The was to was person in the United States I coming Joseph Giyaname in full) father Blue permanently The place in the United States I was going to was new loan The names of some of the persons or passengers I traveled with were (mother) Eva Rutturg I was 5yro wed ADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME FROM OR THROUGH CANADA OR MEXICO: () The place in Canada where I landed was on (Month) (Day) (Year) (b) The place in | Canada 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 (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 GOVERNMENT PRINTING offica 14-8 (OVER) Jacob (Signature Buttery of applicant)

Page data

Page
1073
Source index
0
Type
photo
Media ID
6bc6b7fb32a9ec50
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": "I have notuced this than\nanother name in country that given at the beginning of this form. If so, it was\nI used that name because\n-\nThe name on was\nfull of the person shown my steamship ticket Jacob Butberg\nMy mother's maiden name was\nEva Luchansky\nMy maidon name was (if woman)\nMy post-office 125 montank ave., Seen Longton Can\naddress is\nThe ticket\non which I came to this country was bought at Bremen (City) permany (Country)\nIf was\narrival by ship: Name of steamship line Bremen American\n1st cabin\n2d cabin\nCo.\na\n3d cabin\nI as or\narrived (passenger, stowaway, seaman, member of crew, otherwise) (State which)\npassings\nI traveled on (an immigration visa, a passport, a permit)\npassport\n(State which)\nI paid no head tax at\n, on\n(State amount)\n(City)\n(State or country)\n(Month)\n(Day)\n(Year)\nI was examined by immigration officers at\nEllis n. y\nIsland,\nAt\nthat time I intended to remain (permanently, temporarily, for visit, in transit) (State which)\nThe was to was\nperson in the United States I coming Joseph Giyaname in full) father\nBlue\npermanently\nThe place in the United States I was going to was\nnew loan\nThe names of some of the persons or passengers I traveled with were\n(mother)\nEva Rutturg\nI was 5yro wed\nADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME FROM OR THROUGH CANADA OR MEXICO:\n() The place in Canada where I landed was\non\n(Month)\n(Day)\n(Year)\n(b) The place in\n|\nCanada\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\n(e) If not examined, state why, and give the circumstances of your entry\nCanada\n(f) The place in\nMexico\nwhere I bought my railroad ticket to come to the United States was\nGOVERNMENT PRINTING offica 14-8\n(OVER)\nJacob (Signature Buttery of applicant)"
}