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File numbers 4874 - 5509, 1926-1930

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Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 4940 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 (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 citizen. My name is Mrs. Miss Mr. file my Declaration (Alien should print of or Intention Grochouse *ypewrite here (first true, original, paper) and to correct become name) a ; age, 39- years. Give age last birthday) Also known as (If alien has used any other name in this country, that should be shown I used that name because The full name of the person shown on my steamship ticket My mother's maiden name was tozolis Hefdeka was Lucas name Grachaurti here) My maiden name was (if woman) My personal description is: Color, while ; complexion, fair ; height, 5 feet 17 inches; My present occcupation is Kurfa polishy weight, 160 pounds; color of hair, darknbrown of blue ; color eyes, I was born in Masi, Russian other visible distinctive marks: peaz S an lighted and backs (City of town) (Country) on the 5 day of november 1880 F. My present residence is 91- High (Number and street) Sh (City or town) (County) (State) My post office address is same The place where or Germany I took the ship train which landed me in the United States was Hamburg, , Jusy on (Month) 3, (Day) 19061 ticket on which I came to this country was bought at Pa.u.s. (Year) The The name of the ship or railroad on which I came was Patricia (City) (Country) (OVER)

Page data

Page
131
Source index
0
Type
photo
Media ID
404006693949bcb1
Size
unknown

Document data

ID
159596813
Core
doc
Type
document
DTO data 
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Context sent to Scholar

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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n4940\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\n(NOTE TO CLERK OF COURT.-To guide you in preparing the Declaration: The black face lines on this form contain statements\nin the regular order as they are to appear on the Declaration of Intention.)\nI desire to citizen.\nMy name is\nMrs. Miss Mr. file my Declaration (Alien should print of or Intention Grochouse *ypewrite here (first true, original, paper) and to correct become name) a\n; age, 39-\nyears.\nGive age last birthday)\nAlso known as\n(If alien has used any other name in this country, that should be shown\nI used that name because\nThe full name of the person shown on my steamship ticket\nMy mother's maiden name was tozolis Hefdeka\nwas Lucas name Grachaurti here)\nMy maiden name was (if woman)\nMy personal description is: Color, while ; complexion, fair ; height, 5 feet 17 inches;\nMy present occcupation is Kurfa polishy\nweight, 160 pounds; color of hair, darknbrown of blue\n; color eyes,\nI was born in Masi, Russian\nother visible distinctive marks: peaz S an lighted and\nbacks\n(City of town)\n(Country)\non the\n5\nday of\nnovember 1880 F.\nMy present residence is 91- High (Number and street) Sh (City or town) (County) (State)\nMy post office address is same\nThe place where or\nGermany\nI took the ship train which landed me in the United States was Hamburg,\n, Jusy on (Month) 3, (Day)\n19061\nticket on which I came to this country was bought at Pa.u.s.\n(Year)\nThe\nThe name of the ship or railroad on which I came was\nPatricia\n(City)\n(Country)\n(OVER)"
}