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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5432
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.
Miss
}
George is Coutsahiles
; age,
43
years.
(Alien should print or typewrite here true, original, and correct name)
(Give age last birthday)
My present occupation is store Kiper
My personal description is: Color, write ; complexion, Dark
; height, 5 feet
Brown
Brown
eff
inches;
weight, 140 pounds; color of hair, Black
; color of eyes,
;
other visible distinctive marks: the a left cheek
I was born in
Mochonissia
(City or town)
Turkey
(Conntry)
on the
/
day of
204 W toun At Normich toun
m ay
885
My present residence is
Ct
(Number and street)
(City or town)
(County)
(State)
The place where I took the ship train which landed in the United States Theaus, Greece
or me was
on madgent (Month) may (Day) 14, 1909 (Year)
The name of the ship or railroad on which I came was Themistakes
My last place of foreign residence was
Mostonissia
(City or town)
(Country)
wife
X
}
She
I am The name of my
is
husband
He
}
was born at
, and now resides at
+
,
I am now a subject of and intend to renounce allegiance to Gurge Trite of and title of sovereign and country of which
name now a subject;
or, TheRefullin if citizen of a republic, write name of of gase republic only)
I arrived at the United States immigration port of
ben york (City or town) er.y.
is? y
(State or territory)
(OVER) , on may 14/8 (Give exact month, day, and year) 1909
19 June21200
Page data
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- Type
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Document data
- ID
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- 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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Document source metadata
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Document source extras
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"ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5432\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.\nMiss\n}\nGeorge is Coutsahiles\n; age,\n43\nyears.\n(Alien should print or typewrite here true, original, and correct name)\n(Give age last birthday)\nMy present occupation is store Kiper\nMy personal description is: Color, write ; complexion, Dark\n; height, 5 feet\nBrown\nBrown\neff\ninches;\nweight, 140 pounds; color of hair, Black\n; color of eyes,\n;\nother visible distinctive marks: the a left cheek\nI was born in\nMochonissia\n(City or town)\nTurkey\n(Conntry)\non the\n/\nday of\n204 W toun At Normich toun\nm ay\n885\nMy present residence is\nCt\n(Number and street)\n(City or town)\n(County)\n(State)\nThe place where I took the ship train which landed in the United States Theaus, Greece\nor me was\non madgent (Month) may (Day) 14, 1909 (Year)\nThe name of the ship or railroad on which I came was Themistakes\nMy last place of foreign residence was\nMostonissia\n(City or town)\n(Country)\nwife\nX\n}\nShe\nI am The name of my\nis\nhusband\nHe\n}\nwas born at\n, and now resides at\n+\n,\nI am now a subject of and intend to renounce allegiance to Gurge Trite of and title of sovereign and country of which\nname now a subject;\nor, TheRefullin if citizen of a republic, write name of of gase republic only)\nI arrived at the United States immigration port of\nben york (City or town) er.y.\nis? y\n(State or territory)\n(OVER) , on may 14/8 (Give exact month, day, and year) 1909\n19 June21200"
}