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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5434
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
SEP 21 1928
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
}
Jose (Alien should Da print Silva typewrite here true, Praticante original, and correct name)
; age,
or
34
years.
(Give age last birthday)
My
My personal description is: Color, White ; complexion, medium durk ; height, 5 feet t inches;
present occupation is Screw machine perator
41/4
weight,
138
pounds; color of hair,
Black
; color of eyes,
Brown
;
other visible distinctive marks:
none
I
was born in Ribeira Ceca (City town) da Villa da Riberia (Countrs) granda
or
on the
/
day of nation november st
, 1884
My present residence is 27 (Number and street) Conn (City
Stoumgton
or town)
(County)
(State)
The place where I took the ship train which landed in the United States
or me was
Ponta Del gada
December 12 1915
, on
(Month)
(Day)
(Year)
The name of the ship or railroad on which I came was
My last place of foreign residence was
Riberia (City town) Ceca da Villa da (Country) Reberia grande
Campain
or
am yes married. The name of my
wife
maria do Rosa Costa
She
I
is
hushand
}
was born at
He
, and now resides at
Strington Conn
I am now a subject of and intend to renounce allegiance to
Portugal
(Write name and title of sovereign and country of which now a subject;
or, if citizen of a republic, write name of republic only)
I arrived at the United States immigration port of
Boston
(City or town)
massa chusetts
,
on
December 21 1915
(State or territory)
14-8
(Give exact month, day, and year)
(OVER)
Page data
- Page
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- Source index
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- Type
- photo
- Media ID
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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\n5434\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\nSEP 21 1928\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}\nJose (Alien should Da print Silva typewrite here true, Praticante original, and correct name)\n; age,\nor\n34\nyears.\n(Give age last birthday)\nMy\nMy personal description is: Color, White ; complexion, medium durk ; height, 5 feet t inches;\npresent occupation is Screw machine perator\n41/4\nweight,\n138\npounds; color of hair,\nBlack\n; color of eyes,\nBrown\n;\nother visible distinctive marks:\nnone\nI\nwas born in Ribeira Ceca (City town) da Villa da Riberia (Countrs) granda\nor\non the\n/\nday of nation november st\n, 1884\nMy present residence is 27 (Number and street) Conn (City\nStoumgton\nor town)\n(County)\n(State)\nThe place where I took the ship train which landed in the United States\nor me was\nPonta Del gada\nDecember 12 1915\n, on\n(Month)\n(Day)\n(Year)\nThe name of the ship or railroad on which I came was\nMy last place of foreign residence was\nRiberia (City town) Ceca da Villa da (Country) Reberia grande\nCampain\nor\nam yes married. The name of my\nwife\nmaria do Rosa Costa\nShe\nI\nis\nhushand\n}\nwas born at\nHe\n, and now resides at\nStrington Conn\nI am now a subject of and intend to renounce allegiance to\nPortugal\n(Write name and title of sovereign and country of which now a subject;\nor, if citizen of a republic, write name of republic only)\nI arrived at the United States immigration port of\nBoston\n(City or town)\nmassa chusetts\n,\non\nDecember 21 1915\n(State or territory)\n14-8\n(Give exact month, day, and year)\n(OVER)"
}