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I have not used another name in this country than that given at the beginning of this form. If so, it was
I used that name because
-
The full name of the person shown on my steamship ticket was Terence ballaghu
My mother's maiden name was alice ballagher
My maiden name was (if woman)
/
My post-office address is 5 walmut St. Paucatuk , Connecticut
The ticket on which I came to this country was bought at Wisterly, (City) R, 9 (Country)
USA
|
1st cabin
If arrival by ship: Name of steamship line was White star
2d cabin
3dcabin
3d cabin
I arrived as (passenger, stowaway, seaman, member of crew, or otherwise)
Passenger
(State which)
I traveled (an immigration visa, passport, permit) immugration visa
on a a
(State which)
I paid
head tax at
, on
(State amount)
(City)
(State or country)
(Month)
(Day)
(Year)
I was examined by immigration officers at Ellis Island, new ynk
At that time I intended to remain for in
(permanently, temporarily, visit, transit) (State which)
fermanently
The person in the United States I was coming to was Budget (Give namein
Kelly
full)
The place in the United States I was going to was w testurly Rhode Island
The names of some of the persons or passengers I traveled with were
ADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME FROM OR THROUGH CANADA OR MEXICO:
(a) The place in Canada where I landed was
, on
(Month)
(Day)
(Year)
Canada
(b) The place in
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
Leuence Gallaghae
GOVERNMENT PIMINTING OFFICE
14-
(OVER)
(Signature of applicant)
Page data
- Page
- 1148
- Source index
- 0
- Type
- photo
- Media ID
- 3994e9a99c0f1074
- 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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"pageIndex": 0,
"type": "photo",
"url": "https://s3.amazonaws.com/NARAprodstorage/lz/partnerships-0002/18-0177_US-MA/18-0177_US-MA_21/18-0177_US-MA_-4526886-CTN-Applications-for-Declaration-of--1926-1930/18-0177_US-MA_-4526886-CTN-Applications-for-Declaration-of--1926-1930_01148.jpg",
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"ocrText": "I have not used another name in this country than that given at the beginning of this form. If so, it was\nI used that name because\n-\nThe full name of the person shown on my steamship ticket was Terence ballaghu\nMy mother's maiden name was alice ballagher\nMy maiden name was (if woman)\n/\nMy post-office address is 5 walmut St. Paucatuk , Connecticut\nThe ticket on which I came to this country was bought at Wisterly, (City) R, 9 (Country)\nUSA\n|\n1st cabin\nIf arrival by ship: Name of steamship line was White star\n2d cabin\n3dcabin\n3d cabin\nI arrived as (passenger, stowaway, seaman, member of crew, or otherwise)\nPassenger\n(State which)\nI traveled (an immigration visa, passport, permit) immugration visa\non a a\n(State which)\nI paid\nhead 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 Ellis Island, new ynk\nAt that time I intended to remain for in\n(permanently, temporarily, visit, transit) (State which)\nfermanently\nThe person in the United States I was coming to was Budget (Give namein\nKelly\nfull)\nThe place in the United States I was going to was w testurly Rhode Island\nThe names of some of the persons or passengers I traveled with were\nADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME FROM OR THROUGH CANADA OR MEXICO:\n(a) The place in Canada where I landed was\n, on\n(Month)\n(Day)\n(Year)\nCanada\n(b) The place in\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\nLeuence Gallaghae\nGOVERNMENT PIMINTING OFFICE\n14-\n(OVER)\n(Signature of applicant)"
}