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Form 2213
PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN
5475
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
NOV 7 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
(NOTE TO CLERK OF COURT.-To guide you in preparing the Declaration: The black face lines on this form
contain
statements
in the regular order as they are to appear on the Declaration of Intention.)
I desire to file my Declaration of Intention (first paper) to become a citizen.
Mr.
JOSE CERREIA E NACIO
My name is
Mrs.
Joseph (AMen print Callior typewrite here true, Enos original, and
; age,
19
years.
Miss
should or
correct name)
(Give age last birthday)
Also known as
(If alien has used any other name in this country, that name should be shown here)
I
The full name of the person shown on my steamship ticket was Joseph falling Ents
used that name because Jose barrberreiro
My mother's maiden name was mary tolline berreiro
My maiden name was (if woman)
My present occcupation is Labouder
My personal description is: Color, White ; complexion, Dark
; height,
5 feet to inches;
91/4
weight, 143 pounds; color of hair, Black
; color of eyes, Brown
;
other visible distinctive marks: none
I was
born in villay Rt granco miched Island,
(City or town)
Portagol
(Country)
on the
4th day of november
, 1 908
My present residence is 36 wall st. new Sondon Conn
(Number and street)
stonington
My post
office address is Bas 82, (City (County) born. (State)
or townks
The place where I took the train which landed the United st. michial
stonmytin,
ship or me in States was
Ponta Delgada
on
may
20
1915
The ticket on which I came to this country was bought at (Day) Portugal (Year)
The name of the ship or railroad on which I came was
Cretic (City)
(Country)
(OVER)
014-8
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- Core
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"ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5475\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\nNOV 7 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\n(NOTE TO CLERK OF COURT.-To guide you in preparing the Declaration: The black face lines on this form\ncontain\nstatements\nin the regular order as they are to appear on the Declaration of Intention.)\nI desire to file my Declaration of Intention (first paper) to become a citizen.\nMr.\nJOSE CERREIA E NACIO\nMy name is\nMrs.\nJoseph (AMen print Callior typewrite here true, Enos original, and\n; age,\n19\nyears.\nMiss\nshould or\ncorrect name)\n(Give age last birthday)\nAlso known as\n(If alien has used any other name in this country, that name should be shown here)\nI\nThe full name of the person shown on my steamship ticket was Joseph falling Ents\nused that name because Jose barrberreiro\nMy mother's maiden name was mary tolline berreiro\nMy maiden name was (if woman)\nMy present occcupation is Labouder\nMy personal description is: Color, White ; complexion, Dark\n; height,\n5 feet to inches;\n91/4\nweight, 143 pounds; color of hair, Black\n; color of eyes, Brown\n;\nother visible distinctive marks: none\nI was\nborn in villay Rt granco miched Island,\n(City or town)\nPortagol\n(Country)\non the\n4th day of november\n, 1 908\nMy present residence is 36 wall st. new Sondon Conn\n(Number and street)\nstonington\nMy post\noffice address is Bas 82, (City (County) born. (State)\nor townks\nThe place where I took the train which landed the United st. michial\nstonmytin,\nship or me in States was\nPonta Delgada\non\nmay\n20\n1915\nThe ticket on which I came to this country was bought at (Day) Portugal (Year)\nThe name of the ship or railroad on which I came was\nCretic (City)\n(Country)\n(OVER)\n014-8"
}