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1st cabin
If by ship: Name of steamship line was
2d cabin
3d cabin
I arrived as (passenger, stowaway, seaman, member of crew, or otherwise)
(State which)
I traveled on (an immigration visa, a passport, a permit)
(State which)
I paid
head tax at
, on
(State amount)
(City)
(State or country)
(Month)
(Day)
(Year)
I was examined by immigration officers at
Germany
At that time I intended to remain (permanently, temporarily, for visit, in transit)
(State which)
The
person
in
the United States I was coming to was father Stanistan (Give name in full) gesmont
The place in the United States I was going to was (Shamolam Pa.
The names of some of the persons or passengers I traveled with were mother ad bather
Rozalia Jesmort, Wladyslan gesmant
My
last place of foreign residence was A
(City or town)
(Country)
am yes Poland married. The
{
wife
Feliks Sudget
She
I name of my
is
was born at
husband
He
Kouns, and now resides at Mouich Community said
I am renounce
3 now 6 a subject convent of and intend to Avenue allegiance to (Write x the Republic sovereign and country of which subject;
name and title of now A
Poland
or, if citizen of a Republic, write name of-Republic only)
I arrived at the United States Immigration port of
new ord (City or town) new York,
ADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME From OR THROUGH CANADA OR MEXICO:
newyork
(State or territory)
, on ajur. (Give exact 5 month, day, 1901 and year)
(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
Stanestan Luchy
GOVURNMENT PRINTING
e14-8
(Signature of applicant)
(OVER)
Page data
- Page
- 170
- Source index
- 0
- Type
- photo
- Media ID
- 946e1a06088663bf
- 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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"ocrText": "1st cabin\nIf by ship: Name of steamship line was\n2d cabin\n3d cabin\nI arrived as (passenger, stowaway, seaman, member of crew, or otherwise)\n(State which)\nI traveled on (an immigration visa, a passport, a permit)\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\nGermany\nAt that time I intended to remain (permanently, temporarily, for visit, in transit)\n(State which)\nThe\nperson\nin\nthe United States I was coming to was father Stanistan (Give name in full) gesmont\nThe place in the United States I was going to was (Shamolam Pa.\nThe names of some of the persons or passengers I traveled with were mother ad bather\nRozalia Jesmort, Wladyslan gesmant\nMy\nlast place of foreign residence was A\n(City or town)\n(Country)\nam yes Poland married. The\n{\nwife\nFeliks Sudget\nShe\nI name of my\nis\nwas born at\nhusband\nHe\nKouns, and now resides at Mouich Community said\nI am renounce\n3 now 6 a subject convent of and intend to Avenue allegiance to (Write x the Republic sovereign and country of which subject;\nname and title of now A\nPoland\nor, if citizen of a Republic, write name of-Republic only)\nI arrived at the United States Immigration port of\nnew ord (City or town) new York,\nADDITIONAL FACTS TO BE GIVEN IF ALIEN CAME From OR THROUGH CANADA OR MEXICO:\nnewyork\n(State or territory)\n, on ajur. (Give exact 5 month, day, 1901 and year)\n(a) The place in Canada where I landed was\n, on\n(Month)\n(Day)\n(Year)\n{\nCanada\n(b) The place in\n}\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\nStanestan Luchy\nGOVURNMENT PRINTING\ne14-8\n(Signature of applicant)\n(OVER)"
}